INS and diabetes mellitus: However interestingly, in a TrialNet study blocking the CD28/CD80/CD86 costimulatory axis with CTLA4Ig (Abatacept) in individuals with diabetes, participants with a poor response (resistance: measured by modeling rate of decline of C peptide) had a transient increase in activated B cell reprogrammed costimulatory ligand gene expression, and reduced inhibition of anti-insulin antibodies (54).