The shifting paradigm of a "cure" for type 1 diabetes: is technology replacing immune-based therapies?

Nearly 50 years after the autoimmune nature of type 1 diabetes was discovered, no therapy has been approved to alter the course of the disease at any stage. However, during that same period, technology has been delivering tools to help patients achieve better glycemic control and reduce the burden of the disease. With the imminent arrival of fully automated artificial pancreas systems that will continue to improve control and quality of life, it appears that we are on the verge of a major technological breakthrough that will significantly impact diabetes care. These devices have such a high degree of potential that they are, at times, mentioned as a virtual cure for the disease-a first for technology in this space. As such, these devices will undoubtedly alter the research landscape in a field that has predominantly been occupied by immunotherapies. This article reviews the history of type 1 diabetes and compares and contrasts the advancements that have come from the world of technology and immunology alike at this important crossroads in care that we are currently in.