New study to explore if anti-inflammatory drug can treat type 2 diabetes

Jan 21, 2009

Joslin Diabetes Center scientists are taking groundbreaking research on the role of inflammation in type 2 diabetes to a new level with the launch of a national clinical trial to investigate whether salsalate, an anti-inflammatory drug used for years to manage arthritis pain, can reduce blood glucose levels in people with type 2 diabetes. If successful, the trial could lead one day to an inexpensive way to treat this most common form of diabetes, which has been increasing at epidemic rates in recent years.

About 560 adults with poorly controlled blood glucose levels are being sought to participate for one year in a clinical research study, referred to as Targeting Inflammation with Salsalate in Type 2 Diabetes (TINSAL-T2D). The study is being funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The study will be conducted at Joslin in Boston and at about 20 other medical institutions across the nation.

Initial studies by the Joslin group showed that salsalate was effective to lower blood glucose when given for 3 months, leading to the start of this larger trial of longer duration.

"These are very important studies aimed to test whether reducing inflammation can actually be used to treat diabetes," says principal investigator Steven E. Shoelson, M.D., Ph.D., the Helen and Morton Adler Chair and Associate Director of Research at Joslin Diabetes Center and Professor of Medicine at Harvard Medical School. "Given what we are learning about how type 2 diabetes develops, we think this might be getting at an underlying cause. We hope the study shows that targeting inflammation is a safe and inexpensive way to treat type 2 diabetes. We also hope that reducing inflammation decreases risk for coronary heart disease, which is another theory that we will be testing in a separate clinical study in the coming months."

In the United States, nearly 24 million people have diabetes. Type 2 diabetes accounts for about 90 to 95 percent of diagnosed cases, representing nearly 10 percent of the adult population. Type 2 diabetes, previously called adult onset or non-insulin dependent diabetes, is a disorder in which muscle and fat cells do not use insulin properly. Type 2 diabetes is closely linked to obesity and puts people who have the disease at greater risk for complications, including cardiovascular disease, blindness, kidney disease and amputations. People with type 2 diabetes die at rates two- to four-times higher than those who do not have diabetes.

"Sedentary lifestyle and western diet have been associated with obesity and diabetes," says co-principal investigator Allison B. Goldfine, M.D., Director of Clinical Research at Joslin and Associate Professor of Medicine at Harvard Medical School. "The study medication, salsalate, which is chemically similar to aspirin but has fewer side effects, has been used for more than 40 years in people to treat pain associated with arthritis. Recent studies in people show that salsalate also lowers blood glucose, but further testing on long-term efficacy and safety specifically in patients with diabetes needs to be done."

"The outcome of this study has the potential for significant public health benefit," said Myrlene Staten, M.D., NIDDK's Senior Advisor for Diabetes Translational Research. "If salsalate improves the control of type 2 diabetes, we would have an inexpensive addition to our arsenal of drug options."

In previous studies Drs. Shoelson and Goldfine and their collaborators found that inflammation - an immune system response that normally fights infection and promotes healing - plays a major role in the development of insulin resistance and type 2 diabetes. These researchers were the first to show that a major trigger of inflammation - the transcription factor NF-kB - is activated in fat, liver, and other tissues of the body, perhaps providing the "missing link" between obesity and diabetes.

In a real bench-to-bedside victory, the researchers built on these discoveries by conducting clinical trials in patients with diabetes, testing anti-inflammatory salicylates, which inhibit NF-kB, as insulin sensitizers. In these patients, blood glucose and lipid levels substantially decreased, glucose uptake and utilization improved, and liver glucose production decreased. These findings of improved glycemia were recently confirmed when the drug was given for three months to patients with type 2 diabetes, laying the groundwork for the new clinical trial.

Source: Joslin Diabetes Center

Explore further: German medics report on drug success for Ebola patient

add to favorites email to friend print save as pdf

Related Stories

Washington takes on Uber with its own taxi app

5 hours ago

Washington is developing a smartphone app to enable its taxis to compete head-on with Uber and other ride-sharing services, the US capital's taxi commission said Friday.

Comet 67P/Churyumov-Gerasimenko in living color

5 hours ago

Rosetta's OSIRIS team have produced a color image of Comet 67P/Churyumov-Gerasimenko as it would be seen by the human eye. As anticipated, the comet turns out to be very grey indeed, with only slight, subtle ...

EU clean air, waste laws at risk

6 hours ago

EU Commission chief Jean-Claude Juncker faces a clash with lawmakers after leaked documents Friday revealed his plans to drop laws on clean air and waste recycling.

Recommended for you

Arriving now at gate 42: measles

7 hours ago

(HealthDay)—Traveling through the same U.S. airport gate, one infected passenger transmitted the measles virus to three others within a four-hour time span, illustrating just how easily the virus can spread, ...

Scratch from pet rat kills child; CDC warns of risk

8 hours ago

(HealthDay)—The tragic death from "rat-bite fever" of a 10-year-old San Diego boy highlights the risk carried by the pet rodents, according to a report from the U.S. Centers for Disease Control and Prevention.

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

deatopmg
1 / 5 (1) Jan 21, 2009
and what about low dose naltrexone?

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.