Ekaterine Berishvili, MD, PhD, University of Geneva, Geneva, Switzerland, discusses the key challenges associated with the development of cell-based therapies for type I diabetes. There is currently an insufficient number of cell donors to meet the high demand of patients with type I diabetes that require treatment. Dr Berishvili proposes expanding the cell pool through the transdifferentiation and differentiation of pluripotent stem cells to insulin-producing beta cells, however, notes that this would not necessarily allow the generation of functional islets, given their complexity. Key remaining challenges include recapitulating islet anatomy and function, as well as achieving protection from the host immune system to avoid rejection upon transplantation. This interview took place during the International Society for Cell & Gene Therapy (ISCT) Annual Meeting 2021.