The discovery of insulin transformed type 1 diabetes from an acutely fatal disease to a chronic disease that can be managed with regular insulin administration. New approaches are currently being developed in preventive treatment and stem cell-based therapies that could make it possible to stop or reverse the disease. These new possibilities represent a real prospect of achieving insulin independence for patients with type 1 diabetes. The article discusses exciting developments in the prevention and treatment of this autoimmune disease. He discusses the prospects for halting disease progression and the hurdles to overcome in developing new therapies. The goal of these research directions is to enable patients with type 1 diabetes to live without dependence on regular insulin administration.