THE EFFECTS OF LIPID-LOWERING DRUGS ON METABOLIC CONTROL AND LIPOPROTEIN COMPOSITION IN TYPE-2 DIABETIC-PATIENTS WITH MILD HYPERLIPIDEMIA

Patients with Type 2 diabetes are at increased risk from macrovascular disease whether or not they are hyperlipidaemic. Several factors may contribute to this increased risk including abnormalities of lipoprote in composition. The aim of our study was to determine the effects of l ipid lowering drugs on lipoprotein composition (lipoprotein fractions were separated by sequential flotation ultracentrifugation) and insuli n sensitivity (measured by a modified Harano technique) in 44 patients with mild hyperlipidaemia. All patients had total cholesterol concent rations between 5.2 and 6.5 mmol l(-1) and total triglyceride concentr ations < 3.0 mmol l(-1), and were randomized by minimization to receiv e treatment for 12 weeks with bezafibrate, acipimox, simvastatin or pl acebo. Total cholesterol concentrations were decreased by simvastatin, 5.7 +/- 0.4 to 3.7 +/- 0.6 mmol l(-1) (p < 0.05), due mainly to reduc ed LDL-cholesterol levels (-1.25 mmol l(-1); p < 0.05), and bezafibrat e 5.7 +/- 0.6 to 4.6 +/- 0.4 mmol l(-1) (p < 0.05). The LDL:HDL-choles terol ratio was reduced in the simvastatin group 2.0 +/- 0.5 to 1.2 +/ - 0.3 (p < 0.005). There was no effect of the drugs on glycated haemog lobin or insulin sensitivity. In conclusion bezafibrate and simvastati n improve the lipid profile in Type 2 diabetic patients without advers ely affecting diabetic control.