1.Absolute lack of insulin production, the hall mark of Type 1 diabetes (T1D), can be corrected by pancreas or islet allo-transplantation.Scarcity of donor human pancreas and the requirement for anti-rejection drugs severely limits this therapy for the 20 million T1D in the word.2.Wenotransplantation of islets cannot be carried out safely using current anti-rejection drugs.Naturally occurring immune privileged sites can be used effectively experimentally, but are not suited to human treatment.Such sites can be mimicked by the use of Sertoli cells or immune barriers.Both have been used safely in humans with precautions to assure disease free source pigs and GMP manufacturing.3.We report here the preliminary results of early trials of alginate microencapsulated neonatal islets in adult T1D patients.Doses of such islets varying from 5,000-20,000/kg were delivered into the peritoneal cavity by laparoscopy on one or more occasions and the subsequent clinical course monitored.Only minor adverse reactions were seen and in particular no pig diseases were transmitted to recipients.Clinical responses varied from insulin independence for up to 32 weeks to no lowering of insulin dose.Unaware hypoglycaemia, when present, was uniformly relieved.No clear cut pattern of dose response has been seen so far.The product (DIABECELL(R)) and the transplantation process is being refined and dose seeking phase 2 trials are underway.4.Using intra-peritoneal micro-encapsulated porcine islet transplantation, unaware hypoglycaemia has been relieved with no safety concerns.Further refinements may lead to more consistent reductions in exogenous insulin treatment.