Type 1 diabetes (T1D) is an autoimmune disease where insulin producing pancreatic beta cells are progressively destroyed. In the absence of a cure, exogenous insulin is given to maintain glucose homeostasis. Tolerogenic strategies to halt destruction and facilitate recovery of beta cells are being explored. This disease is under polygenic control; the identification of specific candidate pathways to target for drug discovery or corrective therapy would enhance therapeutic options. Whilst islet transplantation combined with immune suppression has shown some efficacy, the availability of beta cells restricts its general use. Differentiation protocols directing cultured stem cells into pancreatic tissue are under development. The availability of embryonic stem cells from a mouse model of T1D should facilitate dissection of the causes and progression of this disease.