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N Engl J Med 373:22472257 Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, Nissen SE, Pocock S, Poulter NR, Ravn LS, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Buse JB (2016) LEADER Steering Committee

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This observation has generated new questions regarding potential influences such as antibody timing, dye-associated effects, or previously unrecognized surface interactions that may modulate NK cell activity

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Many patients spend years being told their labs are normal