Development and trend of stem cell therapy for diabetes: a comprehensive review based on knowledge visualization.

INTRODUCTION

Type 1 diabetes is characterized by autoimmune destruction of pancreatic β‑cells, whereas type 2 diabetes involves chronic low‑grade systemic inflammation. Stem cell therapy, through both direct cell replacement and immunomodulation, holds great promise for treating diabetes. However, a comprehensive bibliometric analysis systematically mapping the knowledge structure, evolutionary trajectory, and immunological landscape of this field is currently lacking.

METHODS

Using CiteSpace, VOSviewer, and the "bibliometrix" R package, we performed a comprehensive bibliometric analysis of 1,600 publications on stem cell therapy for diabetes retrieved from the Web of Science Core Collection (1995-2025). The analysis focused on the distribution of countries/regions, institutions, and authors, and examined research hotspots and development trends through co‑citation networks, keyword bursts, and cluster analysis.

RESULTS

The field has evolved through four developmental stages: concept validation (before 2007), clinical breakthrough of immune intervention (2007-2014), technological explosion of β‑cell differentiation (2014-2019), and optimization with complication‑oriented expansion (2019-present). Cell replacement and immunomodulation emerged as two core and increasingly prominent paradigms. Keyword burst analysis identified immunology‑related hotspots such as regulatory T cells, macrophage polarization, and exosomes. Mesenchymal stem cells and their exosomes exhibit great potential in immunomodulation and regeneration, opening broad prospects for the treatment of diabetes and its complications.

DISCUSSION: The field is moving toward more refined cell engineering, with notable progress in understanding the mechanisms of β‑cell maturation and differentiation. Future research will place greater emphasis on the development of immune evasion technologies, including the design of novel biocompatible encapsulation materials and the exploration of local immunomodulatory strategies. This will require deep integration of cell biology, immunology, genetic engineering, and clinical medicine to address fundamental issues related to cell function, immune rejection, and long‑term safety, thereby providing safer, more effective, and more universally applicable therapeutic strategies for diabetes.