Given the importance of INS autoantibodies [40,41,42,66,92,93,94,95,96,97,98], as well as anti-GAD and anti-PTPN(IA-2) autoantibodies and TCR [99,100,101,102,103], in T1DM, and the failure of COX antibodies to recognize these antigens, a critical question is whether there needs to be a second microbe that triggers concomitant anti-INS autoimmunity. Here, INS is linked to type 1 diabetes mellitus.