Fifteen years later, the first randomized, double-blind crossover study using nasal delivery of insulin in 38 prediabetic, autoantibody-positive individuals showed an increase in anti-insulin antibodies and a decrease in T cell proliferative responses to insulin, while no acceleration of diabetes development and stable first-phase insulin response to glucose in the 26 individuals who did not develop diabetes was observed at one year [128]. Here, INS is linked to diabetes mellitus.