We have shown the existence of permanent bubbles on Active hydrophobic Spot (AHS) at the luminal aspect of blood vessels.This led us to suggest the Double Cause Hypothesis (DCH) for autoimmune diseases when an autoantigen precursor spill into the blood and being deformed at gas/liquid interface to become autoantigen. Increased spillage of autoantigen precursor from β-cells due to enterovirus infection and elevated AHS due to lipids in the blood are suggested as environmental factors which increase the risk in acquiring T1DM. Further research lines are suggested.