For three decades, I have been coping with type 1 diabetes, a lifelong condition that impairs the body’s ability to produce insulin, a hormone that controls the blood sugar level. Technology has been progressing and enhancing to assist people with type 1 diabetes to monitor and manage their condition more conveniently and effectively. For instance, the Libre 2 system is a device that comprises a sensor patch attached to the skin and a smartphone app that can scan the sensor and display the glucose level. It can also notify the user or their caregiver when the glucose level is too high or too low. However, technology has not yet achieved a permanent cure for type 1 diabetes, which would necessitate restoring the insulin production or replacing the damaged cells in the pancreas. Insulin is a multi-billion pound industry that generates enormous profits for pharmaceutical companies, which may have an impact on the research and development of potential cures for type 1 diabetes. Engineering can play a crucial role in discovering and developing innovative solutions for type 1 diabetes, such as artificial pancreas, islet transplantation, or gene therapy. These technologies can offer hope and promise for people with type 1 diabetes, but they also face many challenges and barriers, such as cost, availability, safety, efficacy, ethics, or regulation. How can we evaluate and compare different types of engineering solutions for type 1 diabetes, such as artificial pancreas, islet transplantation, or gene therapy?