Salsalate improved glycemic control in patients with DM2

January 01, 0001

Salsalate improved glycemic control in patients with DM2

These US authors compared the efficacy and safety of salsalate at different doses in patients with type 2 diabetes. They conducted a parallel randomized trial with computer-generated randomization and centralized allocation. Patients and investigators, including those assessing outcomes and performing analyses, were masked to group assignment. They included persons aged 18 to 75 years with fasting plasma glucose concentrations of 12.5 mmol/L or less (less than 225 mg/dL) and hemoglobin A1c (HbA1c) levels of 7.0% to 9.5% treated by diet, exercise, and oral medication at stable doses for at least 8 weeks. After a 4-week, single-masked run-in period, patients were randomly assigned to receive placebo or salsalate in dosages of 3.0, 3.5, or 4.0 g/d for 14 weeks (27 patients each) in addition to their current therapy.

They found: "Higher proportions of patients in the 3 salsalate treatment groups experienced decreases in HbA1c levels of 0.5% or more from baseline. Mean HbA1c changes were -0.36% at 3.0 g/d, -0.34% at 3.5 g/d, and - 0.49% at 4.0 g/d compared with placebo. Other markers of glycemic control also improved in the 3 salsalate groups, as did circulating triglyceride and adiponectin concentrations. Mild hypoglycemia was more common with salsalate; documented events occurred only in patients taking sulfonylureas. Urine albumin concentrations increased in all salsalate groups compared with placebo. The drug was otherwise well tolerated."

The authors concluded: "Salsalate lowers HbA1c levels and improves other markers of glycemic control in patients with type 2 diabetes and may therefore provide a new avenue for treatment. Renal and cardiac safety of the drug require further evaluation."

If these results hold up in a larger and longer study salsalate should become a standard therapy for DM2.

For the full abstract, click here.

Ann Intern Med 152(6):346-357, 16 March 2010
© 2010 to the American College of Physicians
The Effects of Salsalate on Glycemic Control in Patients With Type 2 Diabetes-A Randomized Trial. Allison B. Goldfine, Vivian Fonseca, Kathleen A. Jablonski, et al. Correspondence to Dr. Shoelson: [email protected].

Category: T. Endocrine/Metabolic/Nutritional, Keywords: diabetes mellitus type 2, DM2, salsalate, glycemic control, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 30 March 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.