Anti-Inflammatory Drug May Prevent Type 2 Diabetes

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Researchers at the Joslin Diabetes Center are reporting that an inexpensive anti-inflammatory drug similar to aspirin, salsalate, may prevent type 2 diabetes by lowering blood glucose and reducing inflammation.

The study, which appears in the February issue of Diabetes Care, is a small, proof-of-principal clinical trial, but is promising enough to spur three more trials to see if the drug, salsalate, can also treat diabetes by lowering blood glucose, slow the progression of coronary artery disease in those with metabolic syndrome, and perhaps prevent diabetes in those at high risk.

"This is exciting because salsalate has a good safety profile after many years of use, is inexpensive to make and appears to have the potential to lower blood glucose," said Allison B. Goldfine, M.D., lead researcher on the study, Director of Clinical Research at Joslin and Assistant Professor at Harvard Medical School. "It may be useful in preventing diabetes."

While it has long been known that high doses of aspirin could reduce blood glucose levels, the risk of stomach bleeding is too high to allow for this treatment to be used, she said. It has also been known for several years that inflammatory markers and proteins are elevated in people with diabetes and that aspirin can reduce inflammation, she noted.

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Animal studies had shown aspirin could be effective, but since it could not safely be used in humans at high doses, the researchers thought about designing a new drug. Goldfine suggested trying salsalate, a non-steroidal, anti-inflammatory medication that is similar to aspirin but does not cause bleeding in patients at risk for diabetes. The inexpensive drug has been used for decades to treat arthritis.

The double-masked, placebo-controlled study of 20 obese young adults found that salsalate substantially reduced blood glucose levels as well as inflammation, and, as a result, may cut their risk of developing type 2 diabetes.

"Our study was the first to look at the metabolic changes that occur when you give salsalate to obese people who have not yet developed diabetes and we're really encouraged by what we found," she said.

The study found that those who took 4 grams of salsalate per day for one month reduced fasting glucose levels by 13 percent and levels of C-reactive protein, a marker for inflammation, by 34 percent. Earlier studies have implicated inflammation in the development of type 2 diabetes and heart disease.

The proof-of-principal study concludes that salsalate reduces glycemia and may improve inflammatory cardiovascular risk indexes in the obese. The findings support the hypothesis that chronic inflammation contributes to obesity-related abnormal blood glucose and suggests that targeting inflammation may provide a therapy for diabetes prevention.

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