The type 1 diabetes grand challenge: The potential for transformative impact from the largest ever investment, £50 million and collaborative thinking across the UK

Eighteen months ago, the opportunity to run a type 1 diabetes grand challenge (T1DGC) was just an aspiration in our strategic plans. We could see the opportunity—the strength of the type 1 researcher community in the UK, the exciting research developments in moving towards a cure, the clinical infrastructure developed by the National Institute of Health and Care Research, the single national health service and the size and diversity of the UK population potentially ready to trial whatever new innovations are in the pipeline. The missing piece was significant funds that enable us to deliver on this potential in the UK. The Steve Morgan Foundation had the foresight, determination and resources to enact this transformative and disruptive change in the UK type 1 landscape. Three themes were selected: cell therapies, immune insights and novel insulins. This commentary focuses on progress to date with the cell therapies theme. As the T1DGC progresses, a series of Diabetic Medicine papers will update on new developments.

From the outset, Steve and Sally Morgan determined that collaboration must be at the heart of new investments, bringing together the UK type 1 community to drive forward innovations at scale to replace or regenerate cell therapies, moving us closer towards a cure. The first step in this partnership between the Steve Morgan Foundation, JDRF UK and Diabetes UK was to invite international experts to join Scientific Advisory Panels (SAPs) to provide independent advice on the best approaches to deliver the type 1 grand challenge themes. Professor Simon Heller is the independent chair of the SAPs. Professor Matthias Hebrok is the vice-chair of the beta cell therapies SAPs supported by Professor Jorge Ferrer, Professor Doug Melton, Professor Lorenzo Piemonti, Professor Lori Sussel and Professor Qizhi Tang. Engaging this international, independent advice has been critical in ensuring we are focusing on areas of research and funding schemes that are going to realise the ambition of the grand challenge. Input from people living with type 1 diabetes has been embedded throughout the grand challenge from setting the priorities, shaping the study designs and reviewing the grant applications, and a type 1 diabetes panel of experts by experience will oversee the growing portfolio of research to ensure it is focused on the needs of people living with type 1.

Working at speed, we appointed three Senior Research Fellows within 6 months of the partnership going live in April 2022. Dr Victoria Salem, Dr James Cantley and Professor Sarah Richardson are working together on innovative programmes to develop soft implants to protect transplanted beta cells, regenerate beta cells in people living with type 1 and understand how immune attacks differ between people with the condition. A subsequent Diabetic Medicine paper from their symposium at the Diabetes UK Professional Conference in April 2024 will showcase the potential of this collaborative fellowship programme.

The imperative to move therapies faster towards clinical care was at the heart of the second funding call focused on collaborative, multidisciplinary translational awards. At the end of 2023, we announced four major, new, complimentary, translational programmes bringing cross-disciplinary teams of researchers together from across the UK and Europe to engineer prosurvival synthetic microenvironments for stem-cell derived islet cells (SC-β), explore if two incretin receptors are molecular targets for precision beta cell therapy, develop microparticles to promote the function of islets following transplantation and assess the potential of Schwann cells and their secretory products to improve SC-β cell maturation and function. A future paper showcasing these translational awards is planned for early next year.

However, we are only at the beginning of this journey. We have yet to deliver stabilized cells for the research community and a rapid clinical trial network for emerging cell therapies. We will be awarding high-risk, high-reward new grants with multidisciplinary thinking at their heart, and by bringing the now hundreds of researchers engaged in the T1DGC together, we hope to continue at pace this transformation, moving our dreams of rapid progress in developing curative options for people living with type 1 from aspirations to much nearer to reality.

To conclude, we are indebted first and foremost to the Steve Morgan Foundation for this vote of confidence in the UK type 1 diabetes community, to the research community, which has really responded to this once-in-a-lifetime opportunity and to emerging partners who are joining us on this exciting journey. There is much to do and no guarantee of success as ever with research, but we are so much farther ahead than we could have imagined back in 2020.