CD4 and type 1 diabetes mellitus: Concordant autoimmune response to oxPTM-INSPs involving simultaneously CD4+ and CD8+ T cells and autoantibodies to oxPTM-INS was seen in 5/18 (27.8%), 6/18 (33.3%) and 4/18 (22.2%) participants with type 1 diabetes for Nt-INSP-4, oxPTM-INSP-6 and oxPTM-INSP-3, respectively (Fig. 6d–f), suggesting that CD4+ T cell response to these peptides is required to generate CD8+ and/or antibody responses to oxPTM-INS.