The effect of gemfibrozil on lipid profile and glucose metabolism in hypertriglyceridaemic well-controlled non-insulin-dependent diabetic patients

We assessed the efficacy of gemfibrozil therapy on lipid profile and glucos e metabolism in a large cohort of (type 2) non-insulin-dependent diabetic p atients. We enrolled 217 type 2 diabetic patients with plasma triglyceride concentrations equal to or above 2 mmol/l: 110 were randomized to gemfibroz il (600 mg twice daily) and 107 to placebo treatment in a double blind fash ion. Each treatment was followed for 20 weeks. To assess postprandial gluco se metabolism and insulin secretion, at time 0 and 20 weeks, a standard mea l containing 12.5 g of proteins, 30.1 g of carbohydrate, 10 g of lipids was given. No differences in demographic characteristics were observed between patients randomized either to gemfibrozil or to placebo therapy. No differ ences were observed in total cholesterol and LDL-cholesterol concentration changes between the baseline observations and week 20 of both treatments. A t variance, both treatments significantly increased HDL cholesterol. Gemfib rozil treatment significantly decreased plasma triglyceride concentration f rom 316 +/- 84 to 214 +/- 82 mg/dl (P < 0.001), whereas with placebo trigly ceride levels increased from 318 + 93 to 380 + 217 mg/dl. No changes were o bserved in non-esterified fatty acid concentrations or in fasting plasma gl ucose concentrations, in HbA(1c) values, insulin and C-peptide concentratio ns. Gemfibrozil treatment: 1) significantly reduces circulating triglycerid e concentration; 2) does not significantly affect cholesterol concentration ; 3) does not worsen glucose metabolism.