Table 1.

Mechanisms underlying impaired adaptive immune response in people with uncontrolled diabetes mellitus.

1. Diminished pathogen-specific memory CD4+ T-cell response [21,28]

2. Impaired B-cell function as B-cells require T-cells for activation into antibody-producing plasma cells [27]

3. Reduced levels of circulating IgG and IgM [22,23]

4. Elevated plasma levels of sCD40L [29]

5. Glycation of circulating immunoglobulins [24,25]

6. Low levels of circulating complements [28]