Effects of bezafibrate on lipid and glucose metabolism in dyslipidemic patients with diabetes: the J-BENEFIT study

A prospective, observational analysis was conducted on 6,407 dyslipidemic patients suffering from diabetes or hyperglycemia who had not received bezafibrate previously. Subanalyses were performed on the concomitant use of diabetes drugs, diabetes duration, and baseline HbA1c levels.Bezafibrate significantly decreased HbA1c irrespective of concomitant use of other diabetes drugs in a baseline-HbA1c-dependent manner, with patients with a shorter diabetes duration showing a greater decrease in HbA1c than those with longer-term disease. The rate of change in triglyceride levels was significantly associated with that in HbA1c. Adverse drug reactions occurred in 306 patients (5.1%), of which reactions in 289 were not severe (94.4%).Bezafibrate significantly improved HbA1c in patients with diabetes given individualized treatment. Bezafibrate may offer clinicians an improved modality for the amelioration of disease course and improvement of outcome in these patients.The prevalence of patients with or at risk of type 2 diabetes is increasing rapidly in Japan, which is in the top 10 of Asian countries with respect to population diagnosed with diabetes and impaired glucose tolerance [1]. Hyperglycemia in patients with type 2 diabetes places them at significant risk for cardiovascular events and other diabetic complications [2], as shown for example by the United Kingdom Prospective Diabetes Study (UKPDS 35), which demonstrated a strong association between the risk of diabetic complications and hyperglycemia [3]. Patients with type 2 diabetes also tend to have higher triglyceride (TG) and lower high-density lipoprotein cholesterol (HDL-C) levels than non-diabetics [4]; for example, Lehto et al. reported that the simultaneous presence of hyperglycemia with either low HDL-C or high TG levels increased the risk of cardiovascular events up to three-fold in patients with type 2 diabetes [5]. Effective treatment of type 2 diabetes must therefore involve the management of blood glucos