The State of Diabetes Research in America
More than 38 million Americans live with diabetes, and roughly 1.2 million of them have type 1. Despite decades of progress, the standard treatments available today still fall short for a large share of patients. Industry reports show that only about 20 to 30 percent of people with type 1 diabetes in the U.S. reach their blood glucose targets, and similar struggles exist in type 2 management. That gap is exactly why research centers from Boston to San Francisco are running trials on everything from dual GLP-1/GIP receptor agonists to stem-cell-derived islet therapies.
The landscape in 2026 is especially active. In June, researchers presented phase 2 results at the American Diabetes Association Scientific Sessions in New Orleans for acmopatide (CT-868), a once-daily dual GLP-1/GIP receptor agonist developed for type 1 diabetes. The study showed improvements in blood glucose control, meaningful weight loss, and a reduction in insulin needs. Around the same time, a large real-world analysis published in Nature Medicine examined more than 174,000 patients with type 1 diabetes and found that GLP-1 receptor agonists were linked to a 15 percent lower risk of major cardiovascular events and a 19 percent lower risk of end-stage kidney disease, without a rise in hospitalizations for diabetic ketoacidosis or severe hypoglycemia. These are the kinds of findings that eventually change clinical guidelines, and every one of them started with volunteers who said yes to a trial.
Why People Hesitate (and Why They Shouldn't)
The most common reasons people give for skipping trials are understandable. Fear of being a "guinea pig" tops the list. Some worry about side effects from experimental treatments. Others assume trials are only for people who have exhausted every other option. And a fair number simply do not know how to find a study that fits their life.
The reality is more reassuring. Every trial in the U.S. is registered on ClinicalTrials.gov, the public database maintained by the National Institutes of Health, and each one must pass an institutional review board before enrolling a single person. The informed consent process is designed to lay out risks, benefits, and alternatives in plain language, and participants can withdraw at any time without penalty. That is not a marketing line; it is a federal requirement.
Another misconception is that trials are only offered at big academic medical centers in coastal cities. While institutions like the University of Wisconsin, Boston Children's Hospital, and the University of California San Francisco run many studies, trials also take place at community clinics, regional hospitals, and research sites in Texas, Florida, Illinois, and beyond. A trial for a stem-cell-derived therapy for type 1 diabetes, for example, currently lists recruiting sites at City of Hope in California, the UHealth Diabetes Research Institute in Miami, Baylor Scott and White Research Institute in Dallas, and the University of Chicago, among others.
What Participation Actually Looks Like
Every study is different, but most diabetes trials follow a similar rhythm. You will attend an initial screening visit to confirm eligibility, which usually involves blood work, a review of your medical history, and a conversation about your current medications. If you qualify, you will be assigned to a treatment group, sometimes by random chance, sometimes not, and you will return for follow-up visits over weeks or months.
Consider the ENRxICH study at the University of Wisconsin, which is recruiting adults with type 2 diabetes to test different models of pharmacy-based support. Participants are assigned to usual care, added medication management from a pharmacist, support from a community health worker, or both. The study is looking for adults aged 18 to 90 with an HbA1c of 7.5 percent or higher who take at least one diabetes medication. It is a reminder that not all trials involve experimental drugs; many test care models, digital tools, and behavioral programs.
For those interested in something more intensive, a study at Boston Children's Hospital is examining how carbohydrate content affects blood glucose and brain function in young adults with type 1 diabetes. Participants receive 12 weeks of delivered meals, use their own CGM and insulin pump, attend up to five in-person visits, and can receive compensation up to $1,300 along with free parking or travel reimbursement.
What to Expect at a Glance
| Study Type | Example | What You Get | Typical Commitment | Best Fit For |
|---|
| Behavioral / Care Model | ENRxICH (UW Madison) | Pharmacist or community health worker support | Multiple visits over months, phone access needed | Adults with type 2 diabetes managing daily meds |
| Diet / Device Study | Boston Children's Hospital T1D diet study | Delivered meals, intensive medical supervision, up to $1,300 | 12 weeks, 5 in-person visits | Adults 18–40 with T1D using pump and CGM |
| Drug / Biologic Trial | VX-880 stem-cell therapy for T1D | Access to investigational treatment | Long-term follow-up at major research sites | People with long-standing T1D and severe hypoglycemia |
| Medication Adjuvant Trial | GLP-1/GIP agonist studies | Investigational once-daily injection | Regular visits, glucose monitoring | People with T1D or T2D who need weight and glucose support |
The Money Question
People ask about compensation more than almost anything else. Policies vary widely by study and by sponsor. Some trials offer reimbursement for time and travel, while others provide study-related care, medication, and devices at no cost to you. The Boston Children's study mentioned above pays up to $1,300. Others pay per visit or cover parking and gas. The American Diabetes Association notes that compensation policies are always explained during the informed consent process, so you will never be surprised by the financial terms if you ask the right questions up front.
What you should not expect is a windfall. Clinical trials are not a side hustle. If a study sounds too lucrative, that is a red flag. Legitimate research compensation is designed to offset your time and expenses, not to make participation financially attractive on its own.
How to Find a Trial Near You
Start with your own care team. Your doctor knows your health history and can tell you whether a research study is a reasonable option given your current glucose control, complications, and medications. Many endocrinology practices have research coordinators on staff who can point you to trials already enrolling at your hospital or nearby.
The most powerful tool, though, is ClinicalTrials.gov. The database is free and public. To use it well:
- Enter "type 1 diabetes" or "type 2 diabetes" as the condition.
- Filter by status and select "Recruiting" to see studies actively enrolling.
- Use the location filter or enter your ZIP code to narrow results by distance.
- Read the eligibility criteria carefully; most studies list them in plain language.
- Contact the study team using the phone number or email listed on the record.
Organizations like the American Diabetes Association and JDRF also maintain trial finders and host educational sessions with trusted community partners. These sessions are designed for people who are curious but not yet ready to enroll, and they are a low-pressure way to learn how research works.
Questions to Ask Before You Enroll
Treat the screening visit like a job interview, except you are the one doing the hiring. Bring a list of questions and do not leave until every one is answered. Good starting points:
- What is the study trying to prove, and what phase is it in?
- Will I receive the investigational treatment, a placebo, or standard care?
- What tests, procedures, and visits are required, and how long will each take?
- What are the known risks and side effects?
- Will my diabetes care team be informed of my participation?
- What happens if I want to leave early?
- What costs will be covered, and what compensation is offered?
- Will I have access to the treatment after the study ends if it works?
A legitimate study team will welcome these questions. If anyone pressures you to sign quickly or downplays your concerns, walk away. There will always be another trial.
A Note on Diversity and Access
Diabetes does not discriminate, but research participation historically has. People of color and those in rural or underserved communities are underrepresented in clinical trials, which means new treatments are sometimes tested on populations that do not reflect who actually uses them. That is changing. Sponsors and academic centers are investing in community health worker programs, mobile research units, and partnerships with local clinics to reach more diverse participants. The University of Wisconsin study is one example; it explicitly recruits English- and Spanish-speaking adults and includes a community health worker arm. If you belong to a community that is often left out of research, your participation is not just good for you; it helps make sure future treatments work for everyone.
Your Next Step
You do not need to be at the end of your rope to join a trial, and you do not need to be perfectly healthy either. Most studies are looking for people with ordinary, everyday diabetes management challenges, because that is the population the treatments are meant to help. Talk to your doctor, browse ClinicalTrials.gov with your ZIP code, and call one or two study teams to ask questions. The worst that happens is you learn something. The best that happens is you gain access to a treatment years before it reaches the pharmacy shelf, and you help shape the standard of care for everyone who comes after you.
研究の知恵