Effect of CRISPR-Cas9 Beta-Cell Editing versus Insulin Therapy on Glycemic Control in Type 1 Diabetic Adults: A Narrative Review

Omagor Jacob

Department of Pharmacology and Toxicology Kampala International University Uganda

Email: jacob.omagor@studwc.kiu.ac.ug

ABSTRACT

Type 1 diabetes mellitus (T1DM) is an autoimmune disorder leading to beta-cell destruction and absolute insulin deficiency, necessitating lifelong insulin therapy. While insulin therapy remains the standard for glycaemic control, it does not address the underlying autoimmune pathology or restore endogenous insulin production. This review compared the effect of CRISPR-Cas9-mediated beta-cell editing with standard insulin therapy on glycaemic control in adults with type 1 diabetes. A narrative review approach was utilised to synthesise published evidence on mechanisms, efficacy, safety, translational feasibility, and ethical considerations of CRISPR-Cas9 beta-cell editing versus insulin therapy. Insulin therapy effectively reduced hyperglycaemia and prevents acute complications, but carries limitations such as hypoglycaemia risk, imperfect glycaemic control, and inability to replicate physiological insulin secretion. Conversely, CRISPR-Cas9 beta-cell editing demonstrates promise in preclinical studies, enabling restoration of insulin production through edited stem-cell-derived beta-like cells or immune modulation to prevent beta-cell destruction. Such editing offers potential durable remission or cure of T1DM. However, clinical translation is limited by challenges in delivery systems, off-target effects, immunogenicity, regulatory approvals, and ethical concerns. No human clinical trial data currently exist to validate safety and efficacy. CRISPR-Cas9 beta-cell editing offers a potential disease-modifying alternative to insulin therapy for type 1 diabetes, though significant translational research is required before clinical adoption. Integrating gene editing with existing insulin management may optimise future therapeutic strategies for durable glycaemic control and improved patient outcomes.

Keywords: CRISPR-Cas9 beta-cell editing, Type 1 diabetes mellitus, Insulin therapy, Glycaemic control, Gene editing therapy.

CITE AS: Mangen Joshua Fred (2025). Effect of CRISPR-Cas9 Beta-Cell Editing versus Insulin Therapy on Glycemic Control in Type 1 Diabetic Adults: A Narrative Review. IDOSR JOURNAL OF APPLIED SCIENCES 10(2):69-72, 2025. https://doi.org/10.59298/IDOSRJAS/2025/102.6972