Aspirin Cousin May Lower Diabetes Risk
Salsalate Improves Glucose Control in Small Study
Jan. 28, 2008 -- A chemical cousin of aspirin that is more than a
century old could prove to be the next big thing for type 2 diabetes
treatment and even prevention if early studies are confirmed, researchers
The nonsteroidal anti-inflammatory drug salsalate is similar to aspirin but
has a much lower risk for stomach bleeding at higher doses. It has been
approved for decades for the treatment of arthritis pain.
In a newly published study, researchers from Harvard Medical School's Joslin
Diabetes Center found that
salsalate had a positive impact on blood sugar levels and inflammation in obese
young adults at risk for developing type 2 diabetes.
The study was small, involving just 20 people who took salsalate or a
placebo for only a month.
But Joslin researcher Allison B. Goldfine, MD, characterized the early
findings as "very exciting," in part because salsalate has been proven
to be a very safe drug over decades of use.
"This drug has been marketed for more than 40 years and the safety
profile looks quite good," she tells WebMD.
Salsalate Targets Inflammation
Earlier studies by the Joslin research team and others suggest that chronic
inflammation plays a major role in obesity-related diseases like type 2
This may explain why very high doses of aspirin have been shown to improve
blood sugar levels in diabetes patients with poor glucose control.
The hope of the Joslin researchers was that salsalate would do the same
thing with much less bleeding risk.
Their latest study included obese people in their 20s treated with either 4
grams of salsalate or placebo daily. Glucose levels were assessed at study
entry and after a month of treatment, as was a key marker of inflammation.
Compared with placebo, salsalate was associated with a 13% reduction in
fasting glucose levels and a 20% reduction in blood sugar response to an oral glucose
tolerance test. The test measures the body's ability to control glucose
after a patient consumes a specific amount of glucose. It can be used to
Treatment with the anti-inflammatory drug was also associated with a 34%
reduction in circulating levels of the inflammation marker C-reactive
"This study is limited by the relatively small sample size and
short-term duration," the researchers write in the February issue of the
journal Diabetes Care. "However, the excellent efficacy ... in this
proof of principle trial does support potential use of anti-inflammatory
modulators for prevention of insulin resistance and diabetes."
More Studies Under Way
The preliminary findings prompted the National Institutes of Health to fund
a much larger trial designed to examine the safety and effectiveness of
salsalate as a treatment for diabetes.
The three-year trial is now under way at 16 diabetes centers across the
A three-month study evaluating salsalate for the prevention of diabetes in
patients at high risk for developing the disease has also been funded, as has a
study examining the drug's impact on cardiovascular disease in high-risk
Joslin researcher Steven Shoelson, MD, PhD, tells WebMD that if early
findings are confirmed, salsalate could prove to be even more beneficial than
the widely prescribed diabetes drug metformin.
The generically available drug would also be much cheaper for patients than
most other drugs used in the treatment of diabetes.
"If we establish that this drug works, it could be the second metformin,
with the added benefit of possibly lowering the risk of cardiovascular
disease" he says.