14 August 2013

Salsalate for Diabetes?

Part 3 of 3 parts

This is in three parts because there are too good points and some information that is not being given out in the high praise for diabetes and this will be necessary for your doctor to determine before you could be given salsalate, if the FDA approves it for diabetes. It is currently being used to treat cancer, osteoarthritis and rheumatoid arthritis, which gives us a plethora of information.

In October 2010, I wrote a blog about salsalate in which I did find a lot to be concerned about and why it may not be right for diabetes. Again, the same researcher at Joslin Diabetes Center, Dr. Allison Goldfine, has another article out on research she has been doing on salsalate. In the first study for 14 weeks, she could only get a 13 percent improvement in blood glucose readings for people with type 2 diabetes. C-reactive protein concentrations (a marker of inflammation) showed improvement of 34 percent. In Stage 2, she is saying salsalate has a 37 percent improvement in blood glucose results in 48 weeks.

Salsalate is an inexpensive means of treating and/or reducing the risk for diabetes in obese young adults by reducing glycemia and lowering inflammation. This is one of the largest benefits. It will be interesting if it can pass the heart disease progression tests which FDA will want proof of before granting its use for diabetes. The highest dosage given in the both stages is 4 grams per day of salsalate.

Stage 1 of TINSAL-T2D (Targeting Inflammation Using Salsalate in Type 2 Diabetes) evaluated varying doses of salsalate in 108 participants with type 2 diabetes for 14 weeks. This study was reported in the Annals of Internal Medicine in 2010. The current findings are based on Stage 2 of TINSAL-T2D, which evaluated 286 participants with type 2 diabetes for 48 weeks. The subjects' blood glucose was inadequately controlled on current diabetes medications. Participants were randomized into salsalate and placebo groups. All patients were continued on the medications they entered the study taking. Participants in both trials using insulin, thiazolidinediones, glucagon-like peptide-1 agonists, NSAIDs, warfarin, or uricosuric agents were not eligible for the study. Reading the warnings shows that these would have severe adverse effects on the study participants.

What is surprising is that patients up to age 75 were included in both Stage 1 and Stage 2 of the study. This will be valuable information for clinicians when the trials are completed and if FDA gives an approval. Maybe, just maybe, some researchers are seeing the need to include the elderly.

Dr. Goldfine is currently leading a heart disease study named TINSAL-CVD to evaluate how salsalate impacts coronary artery plaque volume in patients with established coronary artery disease. The trial results should be available in two years and then we may know if salsalate is a safe drug for use as a diabetes medication. It will be interesting if it can pass the heart disease progression tests which FDA will want proof of before granting its use for diabetes.

Dr. Goldfine was kind enough to send me copies of both studies which is helpful in understanding the more than the Medical News Today was saying that the studies may provide additional evidence that salsalate may be an effective drug to treat type 2 diabetes. One aspect of this is that very few other diabetes medications will match up for stacking medications.

I am looking forward to the end of the latest trial and just how it will fare, which other oral medications it will be allowed to be used with, and if doctors will be issued enough information to prevent problems.

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