Stem cells offer a novel approach to diabetes care based on regeneration, which can potentially shift treatment paradigms towards curation; therapeutic approaches have honed in on generating functional stem cell-derived islet cells for transplantation. Other approaches include stimulating endogenous stem cell replication followed by differentiation into functional islet cells in situ. This review critically considers the impact of diabetes on endogenous stem cells and discusses the potential utility of stem cell therapies for the treatment of diabetes.