**13. Anti-inflammatory treatment**

In diabetes, both Type 1 and Type 2, there are signs of inflammation, partly related to gluco‐ tixicity, partly to other traits of the disease. Thus also in Type 1 diabetes there is an inflamma‐ tory componenent in addition to the autoimmune process. IL-1 has been proposed to be of special importance for the destruction of pancreatic beta cells [90], and blocking IL-1 in ex‐ perimental animals has shown important effects on the disease process. Use of IL-1 inhibitor in Type 1 diabetes has shown reduced serum interleukin 8 (IL-8) levels and reduced CD11b integrin expression on monocytes associated with increased CXCR1 expression. These effects suggest that blocking the IL-1beta pathway results in a reduced ability of mononuclear cells to go to sites of inflammation. However, there is a great gap between studies in animals and and in vitro mechanistic studies, to clinical studies in humans. Recently at the Congress of American Diabetes Association and at the Immunology Diabetes Society the results of two trials blocking the effect of IL-1 in Type 1 diabetes failed. Thus, the use of IL-1r-antagonist showed no effect on preservation of C-peptide or any related clinical parameter[91], and the same was unfortunately the case in another Phase II trial using a IL-1 antagonist, Anakinra [92]. Furthermore blocking IL-1 caused adverse events. Thus, as single therapy using anti-inflam‐ matory drugs is not good enough, but should be tested in combination with other therapies.
