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Anti-inflammatory drug improved glycemia in obese young adults
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Pursuing systemic inflammation in overweight and obese adults may confer a therapeutic means to diabetes prevention.
In a double-masked, placebo-controlled study, researchers from Boston examined the efficacy of the anti-inflammatory drug, salsalate (Disalcid, 3M Pharmaceuticals), for the improvement of glycemia in 20 obese, nondiabetic adults aged <30 years. Participants were randomly assigned to salsalate 4 g per day, divided into two doses, or the same dose of placebo for four weeks.
Salsalate reduced fasting glucose by 13% (P<.002), glycemic response after an oral glucose challenge by 20% (P<.004) and glycated albumin by 17% (P<.0003), compared with placebo. C-peptide levels decreased in the salsalate cohort, despite unchanged insulin levels.
Salsalate also increased adiponectin by 57%, compared with placebo (P<.003), and reduced circulating levels of C-reactive protein by 34% (P<.05). Researchers conclude that inflammatory cardiovascular risk indexes in overweight individuals may improve with the use of this information. – by Stacey L. Adams
Diabetes Care. 2008;31:289-294.
This study is interesting in the sense that the concept of using an anti-inflammatory product to improve glucose control sort of highlights the connection between inflammation and the association with insulin resistance and abnormal glucose metabolism. The proof of concept here is the fact that if you take this anti-inflammatory, you can actually improve your glucose control. As a result of this observation, there is currently a huge, National Institutes of Health-sponsored, multi-center study being conducted to determine the impact of drugs like salsalate on glucose control in people with type 2 diabetes.
This study takes an extension of what people believe as sort of the abnormal pathophysiology that is associated with insulin resistance and abnormal glucose metabolism and analyzes what happens if some of these components or one of these components (in this case the inflammation associated with this problem) is targeted, and it demonstrates that it actually has some value. So now we need to see bigger, longer term studies to determine whether or not this really translates to long-term improved glucose control and better outcomes, and that is essentially the basis of the big, current multi-center study.
– Martin J. Abrahamson, MD
Medical Director of the Joslin Clinic at Joslin Diabetes Center