Although exact mechanisms to account for hyperglycemia-augmented CD4+ lymphocyte differentiation to Th2 and Treg was not clarified in our study, endogenous insulin could affect the differentiation of activated CD4+ lymphocytes, leading to the promotion of Th1 to Th2 differentiation [23], and simultaneously enhance the expression of Foxp3, well recognized as a Treg cell marker [24]. This evidence concerns the gene CD4 and Hyperglycemia.