It is uncertain whether epigenetic changes in beta cells of type 1 diabetics are causal or a consequence of other factors.

“so let's ask that question as a specific example what do you believe or what confidence would would you assign to the notion that the epigenetic change on the beta cells of the type 1 diabetic are indeed causal to the loss of function of the beta cell right so my my last uh exposure to the causes of type 1 diabetes was I in medical school which is more than five years ago but if I I vaguely remember it was an autoimmune disease right so if your poor little helpless beta cells are being attacked by antibodies and macrophases and things those stress reactions are going to cause epigenetic change and whether those epigenetic changes contribute to some extent to the ill fate of the beta cells it's possible”