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A patient with type two diabetes for over 10 years has been taking Victoza injections, 2.4 mg daily plus 1000 mg of metformin twice daily. She sees her diabetologist regularly was told there is no other treatment to lower her HBA1c levels below 6.5. Dr Ross began dosing her with Salsalate 1500 mg, two tablets twice per day and by monitoring the serum level of her salicylic acid level, safety titrated the dose to the therapeutic dose in her case of 2250 mg by mouth twice daily. 12 weeks later her HbA1c level was down to 5.4 which was a 17% reduction in combination with the Victoza and metformin. This 1.1 point decline in the HbA1c is greater than what the manufacturer of Victoza (Novo Nordisk) received FDA approval when they showed only a reduction of a mean of 1 point when Victoza was added to metformin. The patient has had no reported adverse events while on these now three diabetic treatments.
This story illustrates the value of learning from your patients and using the literature to help physicians like Dr Ross think "out of the box" of traditional pharmaceutical companies philosophy that states, "New, synthetic molecules must be made and tested", which is not the case when using Salsalate, a drug made from two molecules of natures safest anti-inflammatory, namely, Salicylic acid.
