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Salsalate, an Aspirin-Like Drug, Shows Promise as a Type 2 Prevention

An aspirin-like drug discovered 132 years ago may prove to be a powerful weapon against type 2 diabetes.

Researchers in a small clinical trial conducted at the Joslin Diabetes Center in Boston report that salsalate, a drug commonly used to treat arthritis inflammation, lowers blood glucose levels and reduces inflammation.

Because of those effects, researchers are now looking into it as an agent to treat, and even prevent, type 2.

Salsalate, a “nonsteroidal, anti-inflammatory medication,” is chemically similar to aspirin but does not cause the stomach bleeding commonly associated with it.

According to Allison B. Goldfine, MD, the study’s lead researcher, scientists have known for a long time that aspirin can reduce blood glucose levels in people with diabetes, as well as the inflammation caused by elevated inflammatory markers and proteins found in people with the disease.

But because the risk of stomach bleeding was too high in people with diabetes, medical experts have shied away from recommending its use. 

Dr. Goldfine recommended testing salsalate as an alternative. So she devised a small double-masked, placebo-controlled study based on 20 obese young adults who were at risk of developing diabetes but had not yet done so.

Members of the test group who took 4 grams of salsalate daily for 30 days experienced a 13 percent reduction in their fasting glucose levels. Their levels of C-reactive protein, a marker for inflammation, dropped by 34 percent.

Given that inflammation is suspected to be a major factor in the development of type 2 diabetes, Dr. Goldfine said it is possible that  salsalate could work to prevent the onset of the disease.

It could also be used as a supplementary treatment for people who already have the disease. Aside from its safety, the drug is cheap to produce and has a usage profile that stretches back to 1876.

Dr. Goldfine’s study, completed earlier this year, has inspired several larger, longer-term studies. One study, “TINSAL-T2D,” funded by the National Institute of Diabetes and Digestive and Kidney Diseases, is using salsalate to target inflammation.

Another study, “TINSAL-IGT,” at the Carl T. Hayden VA Medical Center in Phoenix, is aimed at helping patients with impaired glucose tolerance improve their sensitivity to insulin.

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