Bioactive Materials for Use in Stem Cell Therapies for the Treatment of Type 1 Diabetes

Diabetes is a major challenge to healthcare providers globally, with significant human and financial costs. Type 1 diabetes is expected to effect more than a million people concurrently, with over 130,000 newly identified cases every year (Standl et al., Eur J Prev Cardiol 26(2_suppl): 7-14, 2019; International Diabetes Federation. IDF Diabetes Atlas, 2017). Whilst treatments involving insulin injections have proven to be more successful than transplantations, the rising cost of insulin and donor shortages have prompted researchers to look for more permanent insulin replacement therapy (IRT) options. One of these proposed options has been the immune-isolation and implantation of healthy islets, which can maintain normoglycaemia whilst remaining “invisible” to the endogenous immune system (Correia, Adv Funct Mater 30(26): 1908061, 2020). This chapter will describe the bioactive materials used for Immunoisolative Insulin Replacement Therapy (IRT) and will evaluate the successes and failures of IRT devices, both in the laboratory and in the clinic. We will also discuss the proposed optimizations to the IRT device design for the development of a semi-artificial pancreas, to improve insulin release and islet viability, whilst reducing fibrotic overgrowth and immune response.