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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
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Fenofibrate for Diabetic Retinopathy.

Stephen Stewart1, Noemi Lois1,2

  • 1Department of Ophthalmology, The Belfast Health and Social Care Trust, Belfast, Northern Ireland.

Asia-Pacific Journal of Ophthalmology (Philadelphia, Pa.)
|July 31, 2018
PubMed
Summary

Fenofibrate, a fibric acid derivative, shows promise in treating diabetic retinopathy (DR) in patients with type 2 diabetes. While not routinely prescribed for DR, ongoing trials may solidify its role in managing this diabetes complication.

Keywords:
DMEPDRPPARαdiabetic macular edemadiabetic retinopathyfenofibratepreventionproliferative diabetic retinopathytreatment

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Area of Science:

  • Ophthalmology
  • Endocrinology
  • Pharmacology

Background:

  • Fenofibrate is a common fibric acid derivative for dyslipidemia.
  • Two major trials (FIELD, ACCORD) indicated fenofibrate's benefits for diabetic retinopathy (DR).
  • Experimental studies support fenofibrate's protective effects on retinal vasculature.

Purpose of the Study:

  • To evaluate the efficacy of fenofibrate in managing diabetic retinopathy (DR).
  • To review evidence supporting fenofibrate's use in diabetic patients with DR.
  • To highlight the need for further research on fenofibrate for DR.

Main Methods:

  • Analysis of data from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study.
  • Review of findings from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study.
  • Examination of experimental research on fenofibrate's mechanisms in retinal disease.

Main Results:

  • Fenofibrate demonstrated reduced progression of DR and need for laser treatment in diabetic patients.
  • Beneficial effects include reduced retinal vascular leakage, leukostasis, and cell loss.
  • Fenofibrate downregulates vascular endothelial growth factor (VEGF) implicated in DR.

Conclusions:

  • Fenofibrate shows potential as a treatment for diabetic retinopathy (DR).
  • Despite evidence, fenofibrate is underutilized for DR management.
  • New clinical trials are expected to provide robust data on fenofibrate's efficacy in DR.