Current care for children, adolescents, and young adults with T1D has failed to make meaningful progress in lowering HbA1c despite advances in diabetes technology (6–8) [insulin pumps, continuous glucose monitoring (CGM), and now automated insulin delivery systems, analog insulins (both basal and bolus), and refinements in care delivery, among others] (9). This evidence concerns the gene INS and type 1 diabetes mellitus.