Peroxisome proliferator-activated receptor ligand bezafibrate for prevention of type 2 diabetes mellitus in patients with coronary artery disease

Alexander Tenenbaum ¹, Michael Motro , Enrique Z Fisman

⁰Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, 52621 Israel. altenen@post.tau.ac.il

Circulation +

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May 5, 2004

View abstract on PubMed

Summary

Bezafibrate medication significantly reduced the incidence and delayed the onset of type 2 diabetes in patients with impaired fasting glucose. This study highlights bezafibrate

Area Of Science

Cardiology
Endocrinology
Pharmacology

Background

Type 2 diabetes is preventable through lifestyle changes and glucose-targeting medications.
The role of lipid metabolism-influencing drugs in delaying type 2 diabetes is not well understood.

Purpose Of The Study

To evaluate the effect of bezafibrate, a peroxisome proliferator-activated receptor ligand, on the progression from impaired fasting glucose to type 2 diabetes.
To assess bezafibrate's impact in patients with coronary artery disease over a 6.2-year follow-up.

Main Methods

A randomized controlled trial involving 303 non-diabetic patients with impaired fasting glucose (110-125 mg/dL).
Participants received either bezafibrate retard (400 mg daily) or a placebo.
Follow-up duration was 6.2 years, monitoring new-onset diabetes.

Main Results

New-onset diabetes developed in 42.3% of the bezafibrate group versus 54.4% of the placebo group (P=0.04).
The mean time to diabetes onset was significantly longer with bezafibrate (4.6 years) compared to placebo (3.8 years) (P=0.004).
Bezafibrate treatment was an independent predictor of reduced diabetes risk (HR, 0.70).

Conclusions

Bezafibrate effectively reduces type 2 diabetes incidence and delays its onset in individuals with impaired fasting glucose.
Further research is needed to determine the efficacy of combining bezafibrate with statins and ACE inhibitors for diabetes prevention.

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