I seem to remember the fly in the ointment on the small molecule, endogenous MANF being that it is borne of toxicity. Meaning produced as a result of stressors, or an unwanted effect..... ie not good for you.

I'm sure if Dr Urano could get the body to naturally fight diabetes, that would be the preferred route. Sort of like the goal in immunotherapies. I'm also confident that like most scientists, he is keeping all options open.