Effect of Optimization of Glycaemic Control on Mannan-Binding Lectin in Type 1 Diabetes.

OBJECTIVE

Mannan-binding lectin (MBL) concentration in plasma is increased in subjects with type 1 diabetes and associated with increased mortality and risk of diabetic nephropathy. Recent findings show that pancreas transplantation reduces MBL concentration. Whether the increased MBL concentration is reversed by improved glycaemic control remains unknown. We investigated the effects of improved glycaemic control on MBL concentration in patients with type 1 diabetes.

METHODS

We measured MBL, fructosamine, and HbAat baseline and after 6 weeks in 52 type 1 diabetic patients following the change from conventional insulin therapy to insulin pump therapy.

RESULTS

After initiation of insulin pump therapy, the total daily insulin dose was significantly reduced (from 51 ± 18 IE/day to 39 ± 13 IE/day, < 0.0001). There was a significant decrease in HbA from 8.6% to 7.7% (from 70 mmol/mol to 61 mmol/mol, < 0.0001) and in fructosamine levels (from 356 mol/L to 311 mol/L, < 0.0001). MBL levels decreased by 10% from 2165 g/L (IQR 919-3389 g/L) at baseline to 1928 /L (IQR 811-2758 g/L) at follow-up ( = 0.005), but MBL change was not significantly correlated with changes in insulin dose, HbA, or fructosamine.

CONCLUSIONS

MBL concentration decreased following the initiation of insulin pump therapy in patients with type 1 diabetes and did not correlate with changes in glycaemic control.