Glycated albumin (GA) and the GA/HbA1c ratio are higher in diabetic patients positive for insulin antibodies with high binding capacity and low affinity

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Figure legends

Figure 1: Comparison of GA between InsAb negative (open columns) and InsAb positive (shaded columns) diabetic patients, left panel for type 1 diabetes,

right panel for type 2 diabetes, respectively. The figure shows the individual plots of GA values. In left panel, in type 1 diabetes, n= 12 for InsAb negative

patients (GA= 23.4±1.6%), n= 4 for InsAb positive patients (GA= 31.4±12.4%). The unpaired Student’s t-test was performed for the comparison of two

groups. As a result, the P value is 0.03. In right panel, in type 2 diabetes, n=24 for InsAb negative patients (GA= 21.1±4.7%), n= 8 for InsAb positive patients

(GA= 29.5±10.3%). The unpaired Student’s t-test was performed for the comparison of two groups. As a result, the P value is 0.003. *: P < 0.05, **: P <

0.01, InsAb: insulin antibody, T1D: type 1 diabetes, T2D: type 2 diabetes.

Figure 2: Comparison of the GA/HbA1c ratio between InsAb negative (open columns) and InsAb positive (shaded columns) diabetic patients, left panel

for type 1 diabetes, right panel for type 2 diabetes, respectively. The figure shows the individual plots of GA/HbA1c values. In left panel, in type 1

diabetes, n= 12 for InsAb negative patients (GA/HbA1c= 2.99±0.22), n= 4 for InsAb positive patients (GA/HbA1c= 3.78±0.63). The unpaired Student’s

t-test was performed for the comparison of two groups. As a result, the P value is 0.001. In right panel, in type 2 diabetes, n=24 for InsAb negative

patients (GA/HbA1c= 3.36±0.79), n= 8 for InsAb positive patients (GA/HbA1c= 2.61±0.48). The unpaired Student’s t-test was performed for the

comparison of two groups. As a result, the P value is 0.003. *: P < 0.05, **: P < 0.01, InsAb: insulin antibody, T1D: type 1 diabetes, T2D: type 2 diabetes

14

Table 1 Clinical characteristics of study patients

Type

T1D

T1D

T2D

T2D

InsAb

12

24

Age (years)

62.2 ± 6.7

55.0 ± 22.4

0.316

67.2 ± 10.3

66.8 ± 18.4

0.936

Male (%)

4 (33.3)

2 (50.0)

0.582

7 (29.2)

4 (50.0)

0.298

BMI (kg/m2)

20.2 ± 1.4

18.6 ± 1.4

0.061

25.3 ± 2.2

25.0 ± 3.2

0.764

Duration of insulin therapy (years)

18.2 ± 12.7

2.8 ± 1.5

0.03

10.2 ± 8.2

2.5 ± 3.1

0.02

InsAb binding rate (%)

n.d.

78.9 ± 5.1

n.d.

80.3 ± 10.6

K1 (1/10 M)

n.d.

0.015 ± 0.006

n.d.

0.040 ± 0.039

R1 (10-8 M)

n.d.

70.3 ± 31.1

n.d.

61.6 ± 59.9

HbA1c (%)

7.8 ± 0.5

8.1 ± 2.3

0.68

8.0 ± 0.7

8.8 ± 2.1

0.131

MDI

CSII

Premixed insulin

Basal insulin only

11

DPP-4 inhibitors

11

GLP-1 receptor agonists

Sulfonylureas

-8

Insulin administration method

Antidiabetic medications

15

Biguanides

19

Thiazolidinediones

SGLT-2 inhibitors

Alpha-glucosidase inhibitors

10

InsAb: insulin antibody, T1D: type 1 diabetes, T2D: type 2 diabetes, K1: affinity constant, R1: binding site number, MDI: Multiple daily injection, CSII:

Continuous subcutaneous insulin infusion. The unpaired Student’s t-test was performed to compare two groups (Age, BMI, InsAb binding rate, K1, R1, and

HbA1c). In addition, the χ2 test was performed for the comparison of gender between two groups. P values less than 0.05 were considered statistically significant.

16

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