Based on previous evidences pertaining to tumour microenvironment induced changes in T cells and other studies on T2DM which point towards an exhaustive phenotype, these changes in T cell metabolism and function can most probably be attributed to chronic activation induced T cell exhaustion.34 A study reported that CD26 expression was significantly decreased while ADA activity was significantly increased in T2DM patients which could also explain altered lymphocyte function in T2DM.35 This evidence concerns the gene ADA and type 2 diabetes mellitus.