Fibrate drug may prevent or delay type 2 diabetes

By Will Boggs, MD

NEW YORK, 14 april 2009 - Bezafibrate, a drug widely used in the UK to treat high cholesterol, appears to also prevent or delay the development of type 2 diabetes, according to results of a study reported in Diabetes Care.

Bezafibrate belongs to a group of drugs called fibrates, which are used to lower cholesterol. Bezafibrate, sold under many trade names including Difaterol, Bezatol and Bezalip, is particularly useful in lowering triglycerides and raising high density lipoproteins, the "good" cholesterol.

If additional studies bear out these findings, bezafibrate could become an oral antidiabetic drug that also reduces cardiovascular risk associated with high cholesterol, Dr. James H. Flory told Reuters Health.

Flory, from the University of Pennsylvania School of Medicine, Philadelphia, and colleagues used observational data from the UK's General Practice Research Database. Their hypothesis was that bezafibrate is unique among fibrates in reducing diabetes risk. The study included 12,161 patients on bezafibrate and 4,191 who took other fibrates.

They calculated the incidence of type 2 diabetes among bezafibrate users was 8.5 cases per patient per 1000 years, the authors report, compared with 14.4 cases per patient per 1000 years among users of other fibrates.

Further analysis indicated that the rates of type 2 diabetes were 34 percent lower in the bezafibrate users compared with users of other fibrates.

Moreover, the investigators note, the risk of developing diabetes decreased steadily as the duration of bezafibrate therapy increased.

Among patients with preexisting diabetes, bezafibrate use was associated with a significantly lower risk of progression to needing antidiabetic medication and there was a trend toward a lower risk of progression to requiring insulin therapy, compared with users of other fibrates.

At least one additional study, designed to provide more definitive data, is needed before bezafibrate can be recommended to prevent or treat diabetes, Flory said. "This is especially true in the United States, where bezafibrate is not even on the market."

He added, "Right now it is not clear that any of the available diabetes medications are safe from a cardiovascular standpoint. And bezafibrate would be cheap because it is off-patent. But because it is off patent, industry is not likely to take care of this research for us."

SOURCE: Diabetes Care, April 2009.