Prediabetes, characterized by elevated fasting blood sugar or exaggerated blood sugar
response to sugar ingestion, effects over 79 million adult Americans and is a precursor to
the development of Type 2 diabetes. Importantly, approximately 42% of Iowans (950,000) have
diabetes and 32% (670,000) have prediabetes with the majority of those with prediabetes going
undiagnosed. Adults with prediabetes demonstrate early signs of cardiovascular and nervous
system abnormalities and are at high risk for developing overt diabetes unless aggressive
lifestyle (weight loss, exercise) or pharmacological interventions are employed.
Interestingly, data in recent years has linked obesity and diabetes to chronic inflammation
of the blood vessels and brain areas that regulate blood pressure. Therefore, the current
study will test whether a commonly used aspirin-like anti-inflammatory drug called salsalate,
will improve blood vessel health and nervous system dysfunction in adults with prediabetes.
Eligible subjects will have measurements of blood pressure, blood vessel function in the arms
and eyes, assessments of nerve activity, and blood samples taken before and after 4 weeks of
ingesting an FDA approved aspirin-like drug called salsalate. The study is important because
it will identify a potentially new pharmacological strategy to treat vascular and nervous
system abnormalities in overweight and obese adults with early stage type 2 diabetes using an
inexpensive, generically available drug with an excellent safety record that has been used
for decades to treat chronic inflammatory conditions such as rheumatoid arthritis. If proven
effective, this will provide preliminary support for the concept of targeting inflammation as
a new clinical approach to treating early diabetes related complications. Furthermore, the
current pilot study will provide support for developing a larger clinical trial using
salsalate that could potentially then be extended to patients with type 2 diabetes and
cardiovascular disease, as well as lead to the development of new anti-inflammatory agents
with greater specificity for selective inflammatory pathways.