The future of diabetes mellitus management: Therapeutic insights from gene and stem cell research

Aim: This review will explore the therapeutic potential of gene and stem cell therapy in diabetes mellitus, focusing on the latest developments in CRISPR/Cas9 gene editing, stem cell generated pancreatic beta cells and the hybrid therapeutic approaches in between. Methods: A thorough review of the literature was performed, with the focus being on the mechanisms of gene therapy and stem cell differentiation and their integration with bioengineering technologies. Furthermore, therapeutic targets were identified and clinical trial outcomes were reviewed to determine the translational feasibility of these approaches. Results: Gene therapy has shown potential in regenerating pancreatic beta cells and modulating immune responses through CRISPR/Cas9 based editing and insulin gene transfer. Stem cell based therapies have successfully differentiated into glucose responsive beta cells, and have reduced the need for insulin and enhanced glycemic control. The hybrid gene and stem cell based approaches have shown better durability and immune compatibility in the results and the 3D bioprinting is gradually developing implantable pancreatic tissue constructs. However, there are still some problems to be addressed, including immune rejection, ethical issues and the lack of scalability. Conclusion: Gene and stem cell based interventions are potentially transformative in the management of diabetes, acting on the underlying pathophysiology rather than on symptoms only. These therapeutic modalities when integrated with bioengineering innovations, hold promise for developing curative approaches. However, safety, efficacy and ethical considerations of these critical challenges must be addressed in order to enable widespread clinical implementation of these advancements.