On the horizon:
Needle-free insulin

Since insulin was discovered in 1921, scientists have hoped to develop a way for people with diabetes to receive their daily dosages without injections or invasive pumps. Such a milestone would free almost 4 million Americans from giving themselves insulin shots.

Now, several clinical trials are under way to achieve this goal. According to the American Diabetes Association, scientists are currently evaluating:

• inhalers that contain a dry powdered form of rapid-release insulin that's administered through the mouth deep into the lungs. Once there, air sacs called alveoli move the insulin into the bloodstream.
• insulin spray that's sprayed into the nose or onto the back of the mouth, where it's absorbed by moist tissues and transferred to the blood.
• insulin pills that would either be swallowed or placed between the cheek and gums before meals and dissolved. Insulin currently cannot be taken orally because it's destroyed by stomach enzymes before reaching the bloodstream.
• patches worn on the skin to deliver a low-level, continuous insulin supply.

What about a cure?
Some scientists believe type 1 diabetes may be curable using islet cell transplants from donors. These cells live in the pancreas, producing insulin that regulates blood sugar. In people with diabetes, the body destroys these cells for unknown reasons.

Islet cell transplants have helped some patients resume insulin production; studies have begun to see if this therapy, known as the Edmonton Protocol, provides long-term improvement.