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Salsalate for Type 2 Diabetes Mellitus FREE

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The full report is titled “Salicylate (Salsalate) in Patients With Type 2 Diabetes. A Randomized Trial.” It is in the 2 July 2013 issue of Annals of Internal Medicine (volume 159, pages 1-12). The authors are A.B. Goldfine, V. Fonseca, K.A. Jablonski, Y.D.I. Chen, L. Tipton, M.A. Staten, and S.E. Shoelson, for the Targeting Inflammation Using Salsalate in Type 2 Diabetes Study Team.

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Ann Intern Med. 2013;159(1):I-32. doi:10.7326/0003-4819-159-1-201307020-00001
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What is the problem and what is known about it so far?

Patients with type 2 diabetes mellitus (T2DM) have elevated blood sugar levels, which, if not controlled, lead to both acute and long-term health problems. Many patients continue to have inadequately controlled blood sugar levels even after dietary changes, exercise, or drug therapy.

Salsalate is a drug that has been used for pain treatment for decades. Chemically, it is related to aspirin. Some early evidence suggests that it may lower blood sugar levels in patients with T2DM.

Why did the researchers do this particular study?

To find out whether salsalate can lower blood sugar levels in patients with T2DM and to monitor for possible side effects.

How was the study done?

Patients with established T2DM who were already treated with exercise, dietary changes, or drug therapies (but not insulin) but still had inadequate blood sugar control were invited to participate. Participants were randomly assigned to receive salsalate or placebo once a day. Patients continued their other medications for treatment of T2DM, and their blood sugar as well as other blood levels were observed for 1 year. They were also monitored for side effects. Other changes to their treatments were allowed if needed.

What did the researchers find?

During the 1-year study, markers of blood sugar control were improved in the participants who received salsalate compared with those who received placebo pills. In addition, overall, the participants receiving salsalate were receiving fewer other medications for treatment of T2DM, whereas participants receiving placebo were more likely to require more medications. Blood work results suggested that salsalate reduced inflammation in the body, which may be one way that the drug improved blood sugar control. Some increases in weight and blood lipid levels were seen, as was a marker of reduced kidney function that reversed after salsalate was stopped.

What were the limitations of the study?

The study lasted only 1 year and could not more definitively assess whether the changes in weight, blood pressure, lipid levels, and kidney function posed any long-term problem.

What are the implications of the study?

Salsalate may be a useful treatment of patients with T2DM. Further, longer-term studies are ongoing to assess this possibility.





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