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1) islet cell autoantibodies, 2) autoantibodies to insulin, 3) autoantibodies to glutamic acid decarboxylase (GAD65), and 4) autoantibodies to the tyrosine phosphatases IA-2 and IA-2b ( Figure 3 The majority of T1DM patients also had detectable anti-insulin antibodies before starting insulin therapy, with about 85% of them having circulating islet cell antibodies ( The pancreas has played an important role in managing macronutrient digestion as well as metabolism (energy balance by secreting multiple enzymes for digestion and the pancreas hormones) ( Insulin deficiency minimizes several gene expressions necessary for target tissues to respond normally to insulin-like glucokinase in the liver and the glucose transporter-4 (GLUT 4 ) in adipose tissue