INS and type 1 diabetes mellitus: Increased intestinal permeability, along with elevated levels of serum pro-inflammatory cytokines (e.g., IL-1β, IL-6, and TNF-α) and LPS, were also observed in T1DM.65 It is further suggested that intestinal flora can impact the pathogenesis of T1DM through the production of endotoxins and inflammatory cytokines, which can impair insulin secretion and metabolism.