Lipid-lowering drug delays diabetes in the obese
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Treatment with bezafibrate to lower cholesterol curbs the incidence and delays the onset of type 2 diabetes in obese individuals, doctors in Israel report.
In comments to Reuters Health, sudy leader Dr. Alexander Tenenbaum from Chaim Sheba Medical Center in Tel-Hashomer noted that obesity has reached “epidemic dimensions worldwide” and is clearly associated with type 2 diabetes and metabolic syndrome—a cluster of conditions including high blood pressure, high cholesterol and diabetes.
“Our study,” he continued, “has shown that bezafibrate can reduce the incidence of type 2 diabetes with a magnitude of benefit even better than other medications—41 percent reduction during about 6 years. Moreover, bezafibrate also delayed the onset of diabetes by about 2 years.”
“It seems logical,” Tenenbaum added, that combining bezafibrate with other drugs, such as statins and metformin, might achieve even better results.
In an earlier study, the researchers observed that bezafibrate reduced the incidence of diabetes in patients with impaired fasting glucose levels, a precursor to full-blown diabetes. Theorizing that this effect would also be present in obese individuals with normal fasting glucose levels, the investigators randomized 339 non-diabetic obese patients to 400 milligrams bezafibrate or inactive placebo once daily.
Ninety-eight of the subjects developed diabetes over a median of 6.3 years. Diabetes developed in many more subjects in the placebo arm than in the bezafibrate arm—37 percent versus 27 percent, the team reports in the European Heart Journal.
Moreover, the time to onset of diabetes was significantly longer in the bezafibrate group compared with the placebo group—4 years versus 2 years. In a model adjusting for numerous other factors, bezafibrate therapy independently lowered the risk of developing diabetes by 41 percent.
Bezafibrate has both lowers harmful triglycerides and raises “good” HDL-cholesterol and also reduces blood sugar levels.
The current study, Tenenbaum told Reuters Health, “reinforces the argument that management of atherogenic dyslipidemia in patients with obesity, metabolic syndrome and/or type 2 diabetes should be focused not just on LDL cholesterol, but on triglycerides and HDL cholesterol as well.”
SOURCE: European Heart Journal October, 2005.
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