The mechanism through which salsalate is thought to reduce the production of these inflammatory chemical signals is through the inhibition of IκB kinase resulting in decreased action of NF-κB genes. This mechanism is thought to be responsible for salsalate's insulin-sensitizing and blood sugar lowering properties.
The risk of bleeding is a common concern with use of the NSAID class of medications. However, the bleeding risk associated with salsalate is lower than that associated with aspirin use.
Salsalate has been proposed for the prevention and treatment of type 2 diabetes mellitus due to its ability to lower insulin resistance associated with inflammation and may be useful in prediabetes. However, the use of salsalate to prevent the progression from prediabetes to type 2 diabetes mellitus has received limited study.
Salsalate had been suggested as possible treatment for diabetes as early as 1876.
Salsalate synthesis:DE 211403 and DE 214044 (1909, both to Boehringer, Mann.), Frdl. 9, 928 and C.A. 4, 368 (1910).
^Ebstein, W (1876). "Zur therapie des diabetes mellitus, insbesondere uber die anwendung des salicylsauren natron bei demselben". Berliner Klinische Wochenschrift. 13: 337–340.
^Cavallito, Chester J.; Buck, Johannes S. (1943). "Synthesis of Phenolic Acid Esters. I. Depsides1". Journal of the American Chemical Society. 65 (11): 2140. doi:10.1021/ja01251a034.
^Baker, Wilson; Ollis, W. D.; Zealley, T. S. (1951). "42. Eight- and higher-membered ring compounds. Part II. Di-, tri-, tetra-, and hexa-salicylides". Journal of the Chemical Society (Resumed): 201. doi:10.1039/JR9510000201.