**5. Defects in innate immunity and relation to humoral innate immunity**

The immune system can be divided into innate and adaptive-humoral or cellular immune systems. Concerning the humoral adaptive immunity, serum antibody concentrations in patients with DM are normal and they respond to vaccination with pneumococcal vaccine as well as non-diabetic controls [3, 4]. Furthermore, no differences have been shown in the immune response to intramuscular hepatitis B vaccine between children with DM type 1 and controls [5]. Concerning the adaptive cellular immunity, inhibition of the proliferative response to different stimuli has been observed in the lymphocytes of diabetics with poorly controlled disease [6]. An abnormal delayed-type hypersensitivity reaction (cell-mediated immunity) has also been described in DM type 1 and type 2 patients [7–9].
