There is a growing body of knowledge that points that type 2 diabetes, a chronic disease where the blood sugar increases, is an inflammatory disease. The levels of certain inflammatory chemicals, dubbed as cytokines, are often higher in people with type 2 diabetes, than healthy people. When type 2 diabetes begins to develop, the body becomes less sensitive to insulin, which leads to insulin resistance and inflammation.
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Now, a team of researchers at the University of L'Aquila in Italy have found a novel target for people with type 2 diabetes, using biologic drugs designed for rheumatoid arthritis (RA). The researchers wanted to determine the efficacy of using interleukin-1 (IL-1) inhibition with anakinra, a recombinant human IL-1 receptor antagonist. The drug could potentially improve a person’s glycemic and inflammatory parameters, particularly with those with rheumatoid arthritis and type 2 diabetes.
Type 2 diabetes is a chronic and long-lasting disease if it’s not treated and controlled early. It can lead to many complications, including heart disease, nerve damage, vascular disease, stroke, high blood pressure, kidney damage, slow healing of wounds, hearing problems, and eye damage, to name a few.
The number of people with diabetes has increased from 108 million in 2980 to a staggering 422 million in 2014, the World Health Organization (WHO) reports. In 2016, approximately 1.6 million deaths were directly caused by diabetes, and an additional 2.2 million deaths were linked to high blood glucose.
Link between type 2 diabetes and rheumatoid arthritis
Type 2 diabetes, formerly known as non-insulin-dependent, or adult-onset diabetes, stems from the ineffective use of insulin the body. The condition often results from being overweight or obese, and physical inactivity. In the condition, the pancreas releases or produces adequate amounts of insulin but the cells become insulin resistant, leading to increased blood sugar levels. In some cases, it does not produce enough insulin.
It is a serious disease and an important public health problem. The number of disease is steadily increasing over the past decades. Meanwhile, rheumatoid arthritis is an autoimmune, progressive, and disabling inflammatory disease that causes inflammation and pain in the joints, along with other body organs.
Studies have shown that having inflammatory arthritis, such as rheumatoid arthritis (RA) is linked to an increased risk of developing type 1 and type 2 diabetes. About 47 percent of adults with arthritis also have another chronic condition, like about 16 percent or 7.3 million have type 2 diabetes.
The common denominator of rheumatoid arthritis and type 2 diabetes is inflammation. Both the conditions are characterized by inflammation, which is known to promote insulin resistance, and could lead to type 2 diabetes.
Benefit of IL-1 inhibition
The study, which was published in the journal PLOS, found that IL-1 inhibition may benefit patients with rheumatoid arthritis and type 2 diabetes, reaching the therapeutic targets of both conditions. Now, the researchers suggest that IL-1 inhibition may be a new target treatment for chronic diseases.
To arrive at their findings, the researchers investigated 41 patients with rheumatoid arthritis and type 1 diabetes. From the 41 participants, 39 were eligible for the treatment. A majority of the patients had seropositive RA disease, with active disease. Everyone from the group has type 2 diabetes.
The team randomized the participants in two groups, either the ones who will receive anakinra, a biopharmaceutical drug used to treat rheumatoid arthritis, or tumor necrosis factor (TNF) inhibitors (TNFis), such as certolizumab, pegol, etanercept, golimumab, and infliximab.
“In this study, we observed an apparent benefit of IL-1 inhibition in participants with RA and T2D, reaching the therapeutic targets of both diseases. Our results suggest the concept that IL-1 inhibition may be considered a targeted treatment for RA and T2D,” the researchers said in a study.
The new study could pave the way for the formulation of new therapeutics for patients with Type 2 diabetes, or if the currently used drugs for rheumatoid arthritis can positively impact people with diabetes.
Ruscitti, P., Masedu, F., Alvaro, S., Airo, P., Battafarano, N., Cantarini, L., Cantatore, F., Carlino, G., D’Abrosca, V., Frassi, M., Frediani, B., Iacono, D., Liakouli, V., Maggio, R., Mule, R., Prevete, I., Sinigaglia, L., Valenti, M., Viapiana, O., Cipriani, P., Giacomelli, R. (2019). Anti-interleukin-1 treatment in patients with rheumatoid arthritis and type 2 diabetes (TRACK): A multicentre, open-label, randomised controlled trial. PLOS Medicine. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002901