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Biologic therapeutics are currently not approved for the treatment of patients with type 1 and type 2 diabetes. However, promising results from recent randomized controlled studies suggest that biologic therapeutics have therapeutic potential. This article summarizes the causal steps of the pathogenesis of type 1 and type 2 diabetes which are targeted by biologic therapeutics and reviews the treatment results.

Interleukin-1 receptor antagonist (IL-1Ra) expression is reduced in islets of patients with type 2 diabetes. 70 patients with type 2 diabetes were randomized to treatment with anakinra (IL-1Ra) or placebo for 13 weeks. Following treatment glycated hemoglobin was 0.46 percent lower, C-peptide secretion was enhanced, and systemic IL-6 and C-reactive protein levels were reduced in the anakinra group compared to the placebo group. Insulin resistance remained unchanged. Blocking IL-1 activity improved glycemia and b-cell secretory function and reduced markers of systemic inflammation.