The use of interleukin-1-receptor antagonists in the treatment of diabetes mellitus.

The authors offer views on the role of anakinra, a recombinant human interleukin-1 (IL-1)-receptor antagonist, in treating diabetes mellitus. They identify decreased functional islet β-cell mass as the main cause of type 1 and 2 diabetes onset and progression. A common feature of both types is islet inflammation, which converges on a common pathway leading to β-cell secretory failure and apoptosis. The results of a clinical trial of IL-1 receptor antagonism in diabetics are discussed.