Thirty-five years on from the demonstration that type 1 diabetes has an autoimmune basis, we have learned an enormous amount about the disease. We know its genetic basis (immune genes), its pathological basis (immune cells) and we would expect to be converting this insight into therapeutic advances (immunebased). Certainly, the field of immunotherapy for type 1 diabetesis very active. Here, Mark Peakman reviews the progress being made and scans the horizon for the mostlikely future breakthroughs.