Regenerating β cells of the pancreas - potential developments in diabetes treatment

Introduction: The etiology of diabetes is mainly attributed to insulin deficiency due to the lack of beta cells (type 1), or to insulin resistance that eventually results in beta cell dysfunction (type 2). Therefore, an ultimate cure for diabetes requires the ability to replace the lost insulin-secreting beta cells. Strategies for regenerating beta cells are under extensive investigation. Areas covered: Herein, the authors first summarize the mechanisms underlying embryonic beta cell development and spontaneous adult beta cell regeneration, which forms the basis for developing beta cell regeneration strategies. Then the rationale and progress of each beta cell regeneration strategy is reviewed. Current beta cell regeneration strategies can be classified into two main categories: in vitro beta cell regeneration using pluripotent stem cells and in vivo reprogramming of non-beta cells into beta cells. Each has its own advantages and disadvantages. Expert opinion: Regenerating beta cells has shown its potential as a cure for the treatment of insulin-deficient diabetes. Much progress has been made, and beta cell regeneration therapy is getting closer to a clinical reality. Nevertheless, more hurdles need to be overcome before any of the strategies suggested can be fully translated from bench to bedside.