Figure 1: Overview of the lectin pathway of the complement system and study hypothesis. (a) Specific surface-sugar structures are recognized by MBL that leads to activation of the lectin pathway. The activation proceeds as an enzyme cascade with proteins acting as cofactors for each other thus generating opsonins for enhanced cellular recognition (C3b), anaphylatoxins that drive local inflammation (C3a and C5a), and terminally the membrane-attack complex (C5b-9) that mediates cell lysis. (b) Under normal glycemia MBL is unable to bind host cell-surfaces (left panel). However, during hyperglycemia the cellular surface may be altered, which mediates recognition by MBL and activation of the complement system.