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Brief Description:

A large, new study holds promise for an effective and inexpensive way to treat the most common form of diabetes

Transcript:

Hightower: A new study holds promise for an effective, inexpensive way to treat the most common form of diabetes. The National Institute of Diabetes and Digestive and Kidney Diseases is investigating whether salsalate, an anti-inflammatory drug used for years to manage arthritis pain, can reduce blood glucose levels in people with type 2 diabetes. This clinical trial is based on the promising results of earlier studies showing that salsalate lowered blood sugars when given to diabetes patients for a three-month period. Now researchers want to find out whether the drug will be safe and effective over a longer timeframe. Dr. Steven Shoelson of Harvard Medical School is the principal investigator.

Shoelson: Based on its long history of use in people with joint pain, we believe that it is very safe to use for long periods of time, and a subset of the people that have been treated that had joint pain also have diabetes. Although nobody has asked specifically whether there are any increased number of side effects in those people, now in the bigger trial, in diabetes, specifically, we need to look at that question much more closely.

Hightower: Salsalate, which belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs), is already approved by the Food and Drug Administration to relieve mild to moderate pain, fever, arthritis, and other musculoskeletal conditions.

Shoelson: The big difference is in its mechanism of action—how it actually works. Other drugs lower blood glucose—that’s all good, but they don’t seem to get at a real cause of the problem. And we think that the inflammation that occurs when people gain weight might be getting at that root problem. So when people with diabetes that are overweight, lose some weight through dieting and exercise—and as it improves their diabetes also improves the inflammation, so we thought that a drug that might improve the inflammation might also improve the diabetes, and that’s exactly what we’ve seen.

Hightower: Several large clinical trials have already shown that better control of diabetes leads to fewer, less severe complications, and worse control is associated with more severe complications. Dr. Shoelson explains:

Shoelson: Complications—that word refers to the problems that develop in some people with diabetes after they’ve had it for a longer period of time. This includes problems with the eyes, potentially leading to a loss of vision, kidney problems that can cause kidney failure, nerve problems, and also increased risk of atherosclerosis, which means more heart attacks, strokes, and possibly limb amputations.

Hightower: The outcome of this study has the potential for significant public health benefit because if salsalate improves the control of type 2 diabetes, it would provide a much-needed, inexpensive addition to the current range of drug options. For more information on this trial visit, www.clinicaltrials.gov, and look up the TINSAL-T2D study. This is Dorie Hightower at the National Institutes of Health, Bethesda, Maryland.