Unexpectedly, the combination of GAD65 Alum with TNF-α blocker etanercept led to transient IL-4 elevation, continuous upregulation of IL-17 (P = .004), and a significant increase in IFN-γ and TNF-α (P = .002 and P = .02, respectively) at 1 month posttreatment, failing to produce an inhibitory immunomodulatory effect in patients with recent-onset T1D. Here, TNF is linked to type 1 diabetes mellitus.