Inflammation

Excerpts from Diabetes Self-Management, November/December 2008:

We’re just beginning to understand what chronic inflammation does to the body. We know a bit more about what it does to blood vessels, which is where most of the research has been focused: Chronic inflammation stresses arterial walls and is associated with the development of atherosclerosis, the buildup of fatty deposits in arterial linings.

It’s also becoming clearer that inflammation may be behind insulin resistance, the reduced ability of the cells to respond to insulin, which is a cause of high blood glucose in Type 2 diabetes.

Lifestyle habits over time may play a role in chronic inflammation. “The sedentary lifestyle and excess caloric intake that lead to excess weight gain promote this chronic, sub-acute inflammation, which then participates in the development of Type 2 diabetes.”

It’s possible that simply being overweight triggers inflammation. “Maybe lack of exercise (is a cause),” says Dr Trence. “This is an area where there are a lot more questions than answers, and I think people are beginning to recognize that there may be various factors that play a role.”

Whatever causes inflammation in the first place, its presence creates an unfortunate set of consequences in a few very concrete ways. “The immediate contributions are, first, atherosclerosis, heart attack, and stroke; and second, insulin resistance and Type 2 diabetes,” says Paresh Dandona, M.D., Director of the Diabetes-Endocrinonology Center of Western New York and Chief of the Division of Endocrinology at the Medical School of the State University of New York at Buffalo.

As long as 100 years ago, studies suggested that people who took very high doses of aspirin – about ten 325-mg tablets a day – seemed to experience some improvement in diabetes control, but such a high dose of aspirin has unacceptable side effects. …then we realized that there were other salicylates, chemically similar to aspirin, that don’t carry the same risk of bleeding. The drug they’re studying now, salsalate, was widely used not too long ago to treat arthritis, but it got “back-shelved” when other drugs were developed for the treatment of pain and arthritis.

Enrollment in a new, large study began in September 2008. Those interested should visit the TINSAL-T2D (Targeting Inflammation Using Salsalate for Type 2 Diabetes) website.