Type 1A diabetes mellitus(DMT1 in the following text)is caused by the autoimmune destruction of the insulin-producing beta cells in the islets of Langerhans[1,2].This destruction is determined by genetic susceptibility,such as the presence of HLA-DQalpha,HLA-DQbeta,HLA-DR,preproinsulin,PTPN22 gene,CTLA-4,interferon-induced helicase,IL2 receptor(CD25),lectin-like gene(KIAA0035),and ERBB3e[3–8].It is usually triggered by environmental agents,such as perinatal factors(maternal age over 25 years,preeclampsia,neonatal respiratory disease,and jaundice),viruses(Coxsackie virus,enteroviruses),dietary factors(cow’s milk),exposure to nitrates,and treatment with checkpoint inhibitors[9–14].
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