Aspirin shows promise as adjunctive treatment for type 2 diabetes

מתוך medicontext.co.il

By Esther Csapo Rastegari

BOSTON (Reuters Health) – Researchers at Joslin Diabetes Center here are reaching into the past and reexamining aspirin as a treatment for diabetes, based on its long-recognized ability to lower blood glucose levels.

Senior researcher Dr. Steven E. Shoelson told Reuters Health, "We've been able to combine information already available to make a very exciting discovery."

In the 1950s, aspirin's effect on diabetes was thought to be related to insulin secretion, Dr. Shoelson explained. Research was abandoned when that direction proved unsuccessful. Dr. Shoelson and colleagues "stumbled upon" the old research while trying to understand the cellular pathways at work in diabetes.

Their current research at Joslin has focused on understanding the IKK-beta pathway's inhibitory role on the effects of insulin. The IKK-beta pathway targets one protein of several that are activated during chronic inflammation. The insulin resistance that is characteristic of obesity and hyperglycemia appears to involve an inflammatory process, the Joslin researchers believe. Aspirin appears to exert its anti-inflammatory effect by targeting the cyclo-oxygenases, COX-1 and COX-2.

Researchers studied the effect of high-dose aspirin on insulin resistance in Zucker fa/fa rats and ob/ob mice, which have a genetic defect for obesity and type 2 diabetes. Aspirin therapy resulted in reversal of insulin resistance, with lowered insulin, glucose and triglyceride levels. Insulin resistance remained reversed, however, only with continued administration of aspirin.

In collaboration with pharmaceutical companies, Dr. Shoelson's team is working to develop a "better aspirin" that could be used in the treatment of type 2 diabetes. Dr. Shoelson warns physicians against current use of high-dose aspirin in diabetic patients due to complications such as gastrointestinal bleeding and hepatic and renal damage.

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