AccScience Publishing / JCTR / Online First / DOI: 10.36922/JCTR026150026
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Bone marrow- vs. umbilical cord-derived mesenchymal stem cells for type 2 diabetes mellitus treatment: A systematic review and meta-analysis

Mohamad Faisal Said Al Omar1 ,  Yousef Mohammed Alawi1 ,  Abdelwareth Tayara1 ,  Ahmed Sahwan1 ,  Mazen Mohandes1 ,  Abdullah Almohamad Almustafa1 ,  Khawaja Husnain Haider1*
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1 Department of Basic Sciences, College of Medicine, Sulaiman AlRajhi University, Al Qaseem, Kingdom of Saudi Arabia
JCTR, 026150026 https://doi.org/10.36922/JCTR026150026
Received: 12 April 2026 | Revised: 19 May 2026 | Accepted: 2 June 2026 | Published online: 2 July 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background: Contemporary therapeutic options for type-2 diabetes (T2DM) have limitations. We aim to systematically compare the efficacy of bone marrow (BM)- vs. umbilical cord (UC)-derived mesenchymal stem cells (MSCs) for the treatment of T2DM. Methods: Four databases were searched to identify five Phase II/III randomized controlled trials (RCTs) and two self-controlled clinical trials (293 patients) that used UC- and BM-derived MSCs to assess their efficacy in T2DM during 3–12 months follow-up. Primary outcomes included glycated hemoglobin (HbA1c), fasting blood glucose (FBG), fasting C-peptide (FCP), and daily exogenous insulin requirement; secondary outcomes included stimulated C-peptide, and homeostatic model assessment for insulin resistance were studied. R software, adopting random-effects meta-analytic models, was used to conduct the primary RCT-restricted (intervention vs. control) and secondary supportive meta-analyses. Results: In the primary RCT-restricted analysis, overall pooled effects versus control were frequently heterogeneous and inconsistently significant. However, tissue-source subgroup analyses showed that UC-MSCs had greater reductions in HbA1c and FBG at 6 and 12 months. However, FCP showed preserved or improved levels in UC-MSC arms versus BM-MSC arms at selected time-points. Daily insulin requirements were significantly reduced across all follow-up periods in the intervention groups, without tissue-source superiority. Secondary pre–post analyses supported the overall improvements in glycemic parameters, with recurrent subgroup signals favoring UC-MSCs for HbA1c and FBG. Conclusion: Repeated pattern across multiple time-points suggests that UC-MSCs may provide a more consistent glycemic benefit and reductions in insulin requirements. However, methodologically rigorous RCTs directly comparing UC-MSCs and BM-MSCs are necessary to support a recommendation of tissue-source superiority. Relevance for patients: These data demonstrate the superiority of UC-MSCs in achieving more durable improvements in glycemic control and reduced exogenous insulin requirements compared to BM-MSCs. However, this needs to be substantiated by further clinical evidence.

Keywords
Bone marrow
Diabetes mellitus
Glycemic control
Mesenchymal stem cells
Meta-analysis
Systematic review
Umbilical cord
Funding
None.
Conflict of interest
The authors declare they have no competing interests.
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Journal of Clinical and Translational Research, Electronic ISSN: 2424-810X Print ISSN: 2382-6533, Published by AccScience Publishing
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