Monday, January 26, 2009

Should we put all of our overweight/obese at risk for diabetes patients on anti-inflammatories?
I actually found this article after my husband gave me an article from the Wall Street Journal commenting on an 1876 (!) German journal article that noted that Salsalate improved "diabetics ability to control blood sugars". For those who strongly believe that inflammation 2/2 to obesityin leads to insulin resistance and ultimately diabetes, this is more support for this hypothesis. Based on this study, Shoelson got funding for a much larger NIH funded study that just started.
Keep your eyes and ears open for more to come and don't forget to take your daily Advil.

Diabetes Care. 2008 Feb;31(2):289-94. Epub 2007 Oct 24.

Salsalate improves glycemia and inflammatory parameters in obese young adults.
Fleischman A, Shoelson SE, Bernier R, Goldfine AB.
Harvard Medical School, Boston, Massachusetts, USA.
OBJECTIVE: Sedentary lifestyle and a western diet promote subacute-chronic inflammation, obesity, and subsequently dysglycemia. The aim of the current study was to evaluate the efficacy of the anti-inflammatory drug salsalate to improve glycemia by reducing systemic inflammation in obese adults at risk for the development of type 2 diabetes. RESEARCH DESIGN AND METHODS: In a double-masked, placebo controlled trial, we evaluated 20 obese nondiabetic adults at baseline and after 1 month of salsalate or placebo. RESULTS: Compared with placebo, salsalate reduced fasting glucose 13% (P < 0.002), glycemic response after an oral glucose challenge 20% (P < 0.004), and glycated albumin 17% (P < 0.0003). Although insulin levels were unchanged, fasting and oral glucose tolerance test C-peptide levels decreased in the salsalate-treated subjects compared with placebo (P < 0.03), consistent with improved insulin sensitivity and a known effect of salicylates to inhibit insulin clearance. Adiponectin increased 57% after salsalate compared with placebo (P < 0.003). Additionally, within the group of salsalate-treated subjects, circulating levels of C-reactive protein were reduced by 34% (P < 0.05). CONCLUSIONS: This proof-of-principle study demonstrates that salsalate reduces glycemia and may improve inflammatory cardiovascular risk indexes in overweight individuals. These data support the hypothesis that subacute-chronic inflammation contributes to the pathogenesis of obesity-related dysglycemia and that targeting inflammation may provide a therapeutic route for diabetes prevention.
PMID: 17959861 [PubMed - indexed for MEDLINE]

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