Correspondence on 'Disease activity, cytokines, chemokines and the risk of incident diabetes in rheumatoid arthritis'.

We read with interest the article by Baker et al evaluating possible associations between the rheumatoid inflammatory process and the incidence of diabetes.1 In this work, many cytokines were significantly associated with the risk of diabetes, but only interleukin (IL)-1α and IL-6 were independent predictors.1 Due to the specific study design, the authors did not differentiate between type 1 diabetes (T1D) and type 2 diabetes (T2D), although the prevalence of T1D is expected to be very low, considering the mean age of involved patients.1 However, despite this limitation, these findings are of considerable interest since they furtherly reinforce the idea of a possible pathogenic loop between the rheumatoid inflammatory process and the glucose derangement, making more difficult the management of both diseases.2\n\nIn the study by Baker et al , IL-1α strongly predicted the occurrence of diabetes.1 A growing body of evidence suggests the role of IL-1 family in pathogenesis of T2D, inducing to β-cell apoptosis.2–4 Thus, IL-1 inhibition may be considered a new therapeutic strategy in improving glucose abnormalities, although conflicting results are available in the literature.5–9 A recent large …