Salsalate is s prodrug of salicylic acid composed of two salicylate molecules attached by an ester bond. Salsalate acts as a non-steroidal anti-inflammatory drug (NSAID), producing weak, reversible inhibition of COX-1 and COX-2. Salsalate primarily acts as an analgesic, but also exhibits anti-diabetic activity as well. Salsalate decreases blood glucose levels and increases adiponectin levels. This compound also inhibits expression of insulin resistance-inducing Selenoprotein P, potentially mediated by activation of AMPK and phosphorylation of Foxo1α. Salsalate acts as an anti-inflammatory in the treatment of rheumatoid arthritis, as it inhibits IκB kinase and activation of NF-κB. Additionally, salsalate improves glucose tolerance and downregulates 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) activity in visceral adipose in clinical and in vivo settings.