Previous reports described a VO2peak alteration in patients with T1D and poor glycemic control (Turinese et al., 2017; Moser et al., 2018) which was attributed to impaired insulin sensitivity, micro-vascular defects, poor vascular reactivity, and skeletal muscle mitochondrial dysfunction (Riddell and Peters, 2023). Here, INS is linked to type 1 diabetes mellitus.