January 15, 2026
Breakthrough T1D is the world’s largest and most influential nonprofit focused on type 1 diabetes. Of all the nonprofits working on T1D, it is the most likely and best positioned to facilitate a major step forward.
It has a deep pool of resources, money, and connections. If these resources are optimally deployed, 2026 could be a genuinely extraordinary year for progress toward a cure.
Here, JDCA offers recommendations on how Breakthrough T1D can take action for the best possible chance of delivering genuine cure breakthroughs in the next twelve months. These recommendations are given with the hope and wish of cure breakthroughs at the top of mind.
T1D cure research stands at a pivotal juncture. The landscape of diabetes and Practical Cure research is rapidly evolving: Commercial enterprises continue to deepen their foothold in cell supply research, while early success in cell protection research seeks validation. Breakthrough T1D must adjust its focus and adapt its priorities accordingly.
As we enter 2026, there are five key recommendations for Breakthrough T1D:
- Adopt a Standard Cure Definition
- Restore the Cure as Job #1
- Make Project ACT the Top Priority
- Focus Grants on Cell Protection
- Focus the T1D Fund on Cell Supply
1. Adopt a Standard Cure Definition
A single, standard definition of a ‘cure’ will focus and unify efforts toward a common objective. Without a set definition, researchers and administrators are left to create multiple interpretations, which fragment resources and slow progress. Given the progress in recent years toward cell supply, and more recently, cell protection, now is the time to focus and sharpen, not fragment and dilute.
Recently, Breakthrough T1D’s Chief Medical Officer, Thomas Danne, argued for a standardized definition of cure. He shared in a LinkedIn post that Breakthrough T1D is starting work with an external organization to develop a standardized definition of a functional cure for T1D. This is the first time JDCA has heard or read of a Breakthrough T1D executive publicly committing to a standard definition.
JDCA strongly believes that this is the right course and encourages Breakthrough T1D to move from start to finish as quickly as possible, and that it does not get lost in committee or sidelined by other priorities.
JDCA has argued for a standard definition since our inception. To support, we have offered in the past and continue to offer today a powerful and time-tested definition of a Functional/Practical Cure for T1D. This definition was developed by people living with T1D and is outcome-focused—an essential part of Danne’s goal for a standard cure definition.
2. Restore the Cure as Job #1
Breakthrough T1D has a unique opportunity in 2026 to restore cure research as its number one priority, without ambiguity. This would reverse the long-term shift in resources away from cure research grants, which could greatly accelerate the speed to a cure.
Over the past twenty years, Breakthrough T1D has shifted its central focus from creating a world without T1D tomorrow to managing life with T1D today. JDCA has chronicled this strategic shift through analysis and reports of Breakthrough T1D’s Audited Financial Statements. We have followed the decrease in research grant funding from 70¢ of every dollar raised in 2005 to 37¢ in 2024; the increase in non-cure programs, and the rising internal costs of giving grants from 6¢ to 23¢ per grant dollar in 2024. To our readers, these facts are well known.
More recently, the primary promise used in fundraising events is no longer cure research. Cure research is now listed as one of many objectives. This shift is inconsistent with the donor’s top priority when giving: 97% percent say that supporting cure research is the number one reason they give.
Despite these analytical trends, toward the end of 2024, Breakthrough T1D launched Project ACT (Accelerate Cell Therapies). While the publicly available numbers have not yet changed, Project ACT remains a platform to make restoring the cure job #1.
3. Keep Project ACT the Top Priority
Project ACT is described as the organization’s “top strategic priority.” It is cross-functional, focusing on cell supply, protection, and health, with the ultimate goal of islet transplantation-based curative therapies. The project was a positive development, and on paper, it addresses the T1D community's main priorities.
This platform is a strong foundation to build on. While it made some progress in 2025, much more can be done in 2026:
- Full Funding: Project ACT must be the top priority and supported with record-level funding. If achieved, this will be visible in the research grant numbers and in the P&L.
- Leadership: Project ACT needs a single leader who is on point and accountable for driving performance. To date, Project ACT has no single leader, but it is said to be led by the executive team. Leadership by committee is effective in only a minority of situations. It is not an optimal business model for an organization’s top objective.
- Public, Measurable Goals: Publicize near and long-term objectives for Project ACT. Metrics should drive measurable progress, prioritize research areas that will lead to the largest T1D breakthroughs, and reward success accordingly.
- Regular, Public Updates: Ensure transparency and provide quarterly updates that offer the public and donors an opportunity to engage, ask questions, and learn about successes, failures, and next steps.
4. Focus Grants on Cell Protection
The optimal focus for Breakthrough T1D's grantmaking in 2026 is research projects that aim to protect insulin-producing cells from autoimmune attack. Unlike cell supply research, which has largely moved into the commercial domain, cell protection research is still developing and is not yet broadly attractive to investors.
Breakthrough T1D and other nonprofits are uniquely positioned to ensure these cell supply projects have the funding to move from animal testing to human trials and proof of concept. Without nonprofit involvement, many promising research projects would lack funding and shut down prematurely.
There is only marginal value in nonprofits making significant grants to cell supply research projects. These projects are attracting capital, and many are progressing through human trials. Maintaining nonprofit focus in this area (e.g., creating new stem cell lines) would be a misuse of critical funding that could be used for greater impact elsewhere (e.g., cell protection research).
There are three key practices Breakthrough T1D can do to step-change cell protection research in 2026.
- Greatly increase the number of research grants dedicated to novel solutions.
- In JDCA’s overview of Breakthrough T1D’s contracted research grants in FY24, only sixteen grants tackled cell protection research in vivo. This number must go up substantially.
- Ensure insulin-producing cells are widely available for researchers.
- Breakthrough T1D can remove research barriers by providing preclinical-grade cell lines (for research use only, not yet FDA-approved) to researchers developing cell protection solutions.
- Lay the groundwork for a commercially viable supply of insulin-producing cells.
- Many questions will arise, including application and use, insurance coverage, manufacturing and product quality standards, and ethical considerations related to any new biological medical therapy. This is the year to make strong headway on addressing those questions, preparing key stakeholders, and mapping out potential scenarios.
5. Focus the T1D Fund on Cell Supply
The T1D Fund, founded in 2016, is an independent subsidiary of Breakthrough T1D. Both operate at arm’s length, with separate boards and leadership teams, though ultimate authority rests with Breakthrough T1D. The T1D Fund utilizes venture capital investment techniques to invest in promising companies conducting T1D research. In return, it receives ownership equity.
Unlike Breakthrough T1D, which is a nonprofit and has deep expertise in making grants, the T1D Fund is experienced at investing in and working with commercial enterprises, both large and small.
Today, the T1D Fund has twenty-seven active investments. Eleven are working toward at least part of a Practical Cure, most with a focus on cell supply. This is exactly where the T1D Fund should focus. Cell supply is now largely in the commercial sector, and the T1D Fund is positioned to provide capital and work with smaller companies to bring a scalable cell source to market as rapidly as possible.
A cell supply solution can be realistically marketed within the next decade. However, this will only happen if focus is maintained on this goal and the necessary resources are allocated. Eleven projects are only the beginning; much more can and should be invested.
In our opinion, Breakthrough T1D should use the T1D Fund more aggressively to solve cell supply. An increase in monetary contributions—using a portion of the $178 million in unearmarked funds—is justified. If the impact and reach of the T1D Fund doubles, the speed to a cell supply solution may double as well.
