Fenofibrate Has Beneficial Effects on Lipid Profile But Has No Effect on Glucose Metabolism in Type 2 Diabetic Patients with Hyperlipidemia: a Randomized, Double-Blinded, Placebo-Controlled Trial

Hypolipidemic agent fenofibrate has recently been demonstrated to improve carbohydrate metabolism in animal and cell models. The purpose of this study was to determine its clinical effects on glycemic control and the relationship with its hypolipidemic action in type 2 diabetic patients with hyperlipidemia. Forty-eight type 2 diabetic patients with hyperlipidemia were recruited from the Endocrine Division’s outpatient clinic of a tertiary-care university-affiliated centre and randomly assigned micronised fenofibrate 200mg daily or placebo in a doubleblinded, placebo-controlled study for three months. A total of 44 patients completed the study. Main outcome measured were changes from the baseline in fasting and postprandial lipid and glycemic variables. Treatment with micronised fenofibrate resulted in a significant decrease in fasting (3.81 ± 1.86 to 1.90 ± 0.77 mmol/L, p< 0.0001) and postprandial triglyceride (5.36±2.640 to 2.30±1.33 mmol/L, p< 0.0001), total cholesterol (6.18±1.17 to 5.23±0.97 mmol/L, p<0.0001) and non-HDL cholesterol (5.09±1.12 to 3.96±1.11 mmol/L, p<0.0001). After treatment the placebo group showed no significant changes in serum lipid levels. Both groups did not alter in fasting and postprandial plasma glucose, mean HbA1c, fasting insulin, QUICKI index and proinsulin-to-insulin ratio. Micronised fenofibrate significantly improved both fasting and postprandial lipid profiles, but did not affect glycemic variables, insulin resistance, and β cell function in patients with type 2 diabetes.