The road not taken: A path to curing type 1 diabetes?

The past quarter century has seen a rapid increase in our knowledge about the natural history of autoimmune type 1 diabetes. However, we stand unable to achieve our ultimate goal of preventing or reversing this disease. This Viewpoint discusses controversies in current management of type 1 diabetes, the challenges in translating promising studies from mouse models of the disease to humans, hurdles faced in designing optimal prevention and intervention studies, and potential strategies to overcome these obstacles.