For people with diabetes who also have abnormal levels of blood fats, or lipids, the combination of two types of cholesterol-lowering drugs seems to work better than either one alone. People with diabetes typically tend to have mixed lipid abnormalities, such as high cholesterol and high triglycerides. Much of the cardiovascular risk associated with diabetes may stem from the associated abnormal diabetic lipid profile. This profile, which is characterised by a combination of abnormal lipid parameters, cannot often be rectified by just one drug. Researchers from the LDS Hospital in Salt Lake City, USA, looked at using a combination of simvastatin and fenofibrate for such patients. The researchers randomly allocated 300 patients with type 2 diabetes and mixed lipid abnormalities but no history of heart disease, to daily treatment with simvastatin, fenofibrate, or to both of these agents. After 12 weeks, it was found that the combination therapy was superior to fenofibrate alone in reducing total cholesterol and LDL (bad) cholesterol. Compared to simvastatin alone, it was superior in reducing triglyceride levels. Like in patients with high blood pressure, a multi-drug therapy approach may be necessary. The above results show that the combination of a statin and a fibrate is safe and more effective than monotherapy in improving the lipid profile of diabetic patients.
Journal of the American College of Cardiology,
July 2006