Advances in diabetes for the millennium: toward a cure for diabetes.

What does the future hold for the person with diabetes, since current therapies, including insulin, are all symptomatic and do not address the underlying biology? This article reviews the current state-of-the-art strategies aimed at curing diabetes. The central rationale to curing diabetes revolves around replacing the function of pancreatic islets, either directly through pancreatic/islet transplantation, indirectly through artificial pancreas/beta cells, or via a rebirth of islet function by reprogramming the body to create a new and expanded islet cell mass protected from further assault by autoimmune and other processes. All of these approaches are considered in context of their current status, progress, future challenges or limitations, and long-term prospects for a cure. Although the horizon is in the distance, the advances reviewed in this study predict the future to be bright, and whereas the prospect of islet neogenesis was once considered to be heretical, it is now quite fashionable amongst the scientific community.