Type 1 diabetes, the unfinished business in research
Type 1 diabetes is a serious, chronic autoimmune disease that, while not uncommon, remains largely unknown to the public. More than 166,000 people in Spain suffer from it, 26,000 of them in Catalonia. This disease not only affects patients, who must monitor their glucose levels daily, even while sleeping, and inject insulin every day, but also their families. Type 1 diabetes requires constant, 24-hour monitoring, continuous insulin use, and rigorous glucose control between 4 and 10 times a day. The risks of complications are high: severe hypoglycemia, blindness, amputations, or heart attacks. Furthermore, its diagnosis has a significant emotional, physical, and economic impact on patients and their families. In Catalonia, 1 in 42 families lives with the disease, a figure that will continue to rise in the coming years.
The disease requires a multidisciplinary approach that guarantees comprehensive patient care, including endocrinologists, nutritionists, pediatricians, psychologists, and diabetes educators; but also one that guarantees human and financial resources for research into preventive and curative therapies that will change the outlook for people with type 1 diabetes and their families.
And although Spain is the leading European power in clinical research and the fourth country in the world in initiating clinical trials in patients, only behind the United States, China, and Japan, this is not reflected in clinical trials for type 1 diabetes, since currently only 4 out of 39 are initiating clinical trials.
This is highlighted in the report Clinical studies in type 1 diabetes: the unfinished businessThe report, prepared by the DiabetesCERO Foundation, warns of the lack of clinical trials in type 1 diabetes, calls for boosting clinical research, and proposes creating a national network to promote research and development of innovative therapies in type 1 diabetes with the aim of strengthening the country's scientific leadership in this field.
Barcelona, a strategic center in southern Europe
In fact, Spain, with Barcelona as a strategic hub in Southern Europe, is emerging as a European leader in initiating clinical trials, driven by the strength of its healthcare system. Currently, Barcelona and Madrid concentrate the greatest research activity. Specifically, the Hospital Clínic of Barcelona is the only center participating in three of the four ongoing studies, thus consolidating its position as a national leader in research into new therapies for type 1 diabetes. Furthermore, the Vall d'Hebron University Hospital and the Sant Joan de Déu Hospital in Barcelona also have an active role in these clinical trials. Increasing these scientific studies in type 1 diabetes would allow for the evaluation of more therapies to halt the autoimmune destruction of insulin-producing cells. Although cell therapies are currently more advanced, immunomodulatory strategies are also gaining prominence, an approach reinforced by the recent Nobel Prize in Medicine 2025.
At the DiabetisCERO Foundation, we advocate for investment in preclinical research for type 1 diabetes, because without research there are no clinical trials, and without clinical trials there is no care. Therefore, if clinical trials for type 1 diabetes are eliminated, our patients will also be left without care.
However, the solution is not so far off. Spain, Catalonia, and Barcelona have a proven human, institutional, and healthcare capacity to lead clinical trials. This quality has already been amply demonstrated. Strengthening this capacity by creating a national network of clinical centers for type 1 diabetes, aligned with European standards, would facilitate attracting international trials and put our country on the radar of global sponsors of clinical studies for this disease. This strategic decision would not only benefit patients but would also attract more investment, skilled jobs, and technology to modernize hospitals, train professionals, and strengthen public healthcare. Undoubtedly, a winning decision.
In Europe, we already have the inspiring examples of other countries such as Germany, which leads clinical trials in type 1 diabetes; France, which has specialized national centers; and Denmark, with an integrated research model for this disease. And, of course, we have the pan-European INNODIA network, which has already begun to gain momentum in Spain with the incorporation of leading hospitals and partners, such as the DiabetesCERO Foundation, that give patients—the true protagonists—a voice and a vote. Putting the patient at the center of clinical trials and humanizing their experience can make the difference between success and a lack of participation.
We have all the necessary stakeholders to guarantee the path toward better care for type 1 diabetes. A long and complex path, where each clinical trial is a step toward a better life for thousands of people who hope for and deserve a future without diabetes. This is how we, the more than 3,000 people who make up the DiabetesCERO Foundation, understand it.
