Diabetes & Metabolism Journal

Original Article

Therapeutic Target Achievement in Type 2 Diabetic Patients after Hyperglycemia, Hypertension, Dyslipidemia Management: Ah Young Kang, Su Kyung Park, So Young Park, Hye Jeong Lee, Ying Han, Sa Ra Lee, Sung Hwan Suh, Duk Kyu Kim, Mi Kyoung Park; Diabetes Metab J. 2011;35(3):264-272. Published online June 30, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.3.264

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Background

Our study group established "3H care" in 2002. The meaning of "3H care" attain and maintain adequate controls over hypertension, hyperlipidemia, and hyperglycemia in type 2 diabetic patients. This study evaluated the achievement of target goals after one year or more of "3H care" by specialists in our diabetic clinic.

Methods

This was a retrospective study of 200 type 2 diabetic patients who received "3H care" for one year or more in our diabetic clinic. We evaluated achievement of target goals for metabolic controls as suggested by the American Diabetes Association.

Results

Overall, 200 type 2 diabetes patients were enrolled, of whom 106 were males (53%) and 94 were females (47%). After one year of "3H care," the mean HbA1c was 7.2±1.5% and the percentage of patients achieving glycemic control (HbA1c <7%) was 51.8%. However only 32.2% of hypertensive patients achieved the recommended target. After one year of "3H care," the percentages of those who achieved the target value for dyslipidemia were 80.0% for total cholesterol, 66.3% for low density lipoprotein cholesterol, 57.9% for triglyceride, and 51.8% for high density lipoprotein cholesterol. The percentage that achieved all three targets level was only 4.4% after one year and 14.8% after two years.

Conclusion

The results of this study demonstrate that only a minor proportion of patients with type 2 diabetes achieved the recommended goals despite the implementation of "3H care." It is our suggestion that better treatment strategies and methods should be used to control hypertension, hyperlipidemia and hyperglycemia.

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Alexis Marcotte-Chénard, René Maréchal, Ahmed Ghachem, Alan Cohen, Eléonor Riesco
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Tariku Shimels, Melesse Abebaw, Gebremedhin Beedemariam Gebretekle
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Prevalence and correlation of glycemic control achievement in patients with type 2 diabetes in Iraq: A retrospective analysis of a tertiary care database over a 9-year period
Abbas Ali Mansour, Nassar T.Y. Alibrahim, Haider A. Alidrisi, Ali H. Alhamza, Ammar M. Almomin, Ibrahim Abbood Zaboon, Muayad Baheer Kadhim, Rudha Naser Hussein, Hussein Ali Nwayyir, Adel Gassab Mohammed, Dheyaa K.J. Al-Waeli, Ibrahim Hani Hussein
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Ping Zhou, Weijie Xie, Xiangbao Meng, Yadong Zhai, Xi Dong, Xuelian Zhang, Guibo Sun, Xiaobo Sun
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Association of Self-Reported Dietary and Drug Compliance with Optimal Metabolic Control in Patients with Type 2 Diabetes: Clinic-Based Single-Center Study in a Developing Country
Thilak Priyantha Weerarathna, Miyuru Kavinda Weerarathna, Vidarsha Senadheera, Herath Mudiyanselage Meththananda Herath, Gayani Liyanage
Journal of Nutrition and Metabolism.2018; 2018: 1. CrossRef
Prevalence of primary aldosteronism among patients with type 2 diabetes
Mauro Tancredi, Gudmundur Johannsson, Björn Eliasson, Robert Eggertsen, Ulf Lindblad, Sofia Dahlqvist, Henrik Imberg, Marcus Lind
Clinical Endocrinology.2017; 87(3): 233. CrossRef
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Ursodeoxycholic acid and 4-phenylbutyrate prevent endoplasmic reticulum stress-induced podocyte apoptosis in diabetic nephropathy
Ai-Li Cao, Li Wang, Xia Chen, Yun-Man Wang, Heng-Jiang Guo, Shuang Chu, Cheng Liu, Xue-Mei Zhang, Wen Peng
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Withania coagulansFruit Extract Reduces Oxidative Stress and Inflammation in Kidneys of Streptozotocin-Induced Diabetic Rats
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Response

Response: A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients (Korean Diabetes J 2010;34:359-67): Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim; Diabetes Metab J. 2011;35(1):88-89. Published online February 28, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.1.88

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Original Articles

A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients: Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim; Korean Diabetes J. 2010;34(6):359-367. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.359

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Abstract PDF PubReader

Background

There have been few clinical studies on 10 mg atorvastatin as a starting dosage for treatment of hypercholesterolemia in type 2 diabetes mellitus (T2DM) patients. This retrospective study aims to evaluate the efficacy of 10 mg dosage of atorvastatin in clinical setting.

Methods

One hundred five enrolled patients with high levels of low density lipoprotein cholesterol (LDL-C, > 100 mg/dL) took 10 mg atorvastatin. After 6 months, they were divided into 'Responder group' (LDL-C < 100 mg/dL) and 'Non-responder group' (LDL-C ≥ 100 mg/dL), and the response rate was calculated. Thereafter, we subdivided the 'Responder group' into Maintenance (10 mg), Reduced dosage (5 mg), and Discontinuance group (0 mg). The 'Non-Responder group' was subdivided into Maintenance (10 mg) and Double dosage group (20 mg). After consecutive 6 months, the response rates of each 10 mg Maintenance groups were compared to those of the other groups, respectively.

Results

Following the first 6 months, the response rate of 10 mg fixed dosage was 74.3%. In the 'Responder group', response rates of 10 mg, 5 mg and Discontinuance groups following 6 months were 52.6%, 53.1%, and 12.5%, respectively. In the 'Non-responder group', response rates of 10 mg and 20 mg groups were 28.6% and 50.0%. Baseline LDL-C levels and body mass index (BMI) of 'Responder group' were significantly lower than those of 'Non-responder group' (P = 0.004, respectively).

Conclusion

Hypercholesterolemia treatment with 10 mg, fixed dosage of atorvastatin was effective in three quarters of the subjects during the first 6-month treatment; however, a significant number of patients with high LDL-C levels and/or BMI require higher starting and maintenance dosage.

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Preparation and Release Behavior of Atorvastatin Calcuim - Encapsulated Polyoxalate Microspheres
Cheon Jung Lee, Su Young Kim, Hyun Gu Lee, Jaewon Yang, Jin Young Park, Se Rom Cha, Dong-Kwon Lim, Dongwon Lee, Gilson Khang
Polymer Korea.2014; 38(5): 656. CrossRef
A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients (Korean Diabetes J 2010;34:359-67)
Eun-Jung Rhee
Diabetes & Metabolism Journal.2011; 35(1): 86. CrossRef
Response: A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients (Korean Diabetes J 2010;34:359-67)
Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim
Diabetes & Metabolism Journal.2011; 35(1): 88. CrossRef

Cause-of-Death Trends for Diabetes Mellitus over 10 Years.: Su Kyung Park, Mi Kyoung Park, Ji Hye Suk, Mi Kyung Kim, Yong Ki Kim, In Ju Kim, Yang Ho Kang, Kwang Jae Lee, Hyun Seung Lee, Chang Won Lee, Bo Hyun Kim, Kyung Il Lee, Mi Kyoung Kim, Duk Kyu Kim; Korean Diabetes J. 2009;33(1):65-72. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.65

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Abstract PDF

BACKGROUND
Recently, diabetic mortality is lower than ever before, likely due to dramatic improvements in diabetes care. This study set to analyze changes in the cause of death in type 2 diabetes mellitus (T2DM) in the past 10 years. METHODS: All subjects were T2DM patients over the age of 30 whose death certificates were issued at six hospitals in the Busan metropolitan area from 2000 to 2004. The patients were excluded if they had been clinically diagnosed with significant tuberculosis, liver, thyroid, renal, connective tissue diseases and cancers, prior to T2DM diagnosis. We classified the cause of death into several groups by KCD-4. The results were compared with published data on the period from 1990 to 1994. RESULTS: The study comprised 680 patients, of which 374 (55.0%) were male. The average age of death was 66.3 +/- 10.7 years. The most common cause of death was cardiovascular disease (30.6%), followed by infectious disease (25.3%), cancer (21.9%), congestive heart failure (7.1%), renal disease (4.7%), liver disease (2.7%), and T2DM itself (1.9%). In the study from the earlier period, the most common cause of death was also cardiovascular disease (37.6%), followed by infectious disease (24.2%), T2DM (6.0%), liver disease (5.4%), cancer (4.7%), and renal disease (3.3%). CONCLUSION: Over both study periods, the first and second cause of death in T2DM were cardiovascular disease and infectious disease, respectively. However, death by cerebral infarction among cardiovascular disease patients was significantly lower in the latter period, while death by malignancy was markedly increased.

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Adiponectin Concentrations in Type 2 Diabetic Patients with or without Metabolic Syndrome.: Ja Young Park, Ja Won Kim, Ji Min Kim, Ying Han, Soo Kyung Park, Ji Young Mok, Mi Kyoung Park, Hye Jeong Lee, Duk Kyu Kim; Korean Diabetes J. 2008;32(3):224-235. Published online June 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.3.224

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Abstract PDF

BACKGROUND
Adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism. The aim of this study was to evaluate the relationship between serum adiponectin concentrations and metabolic syndrome (MS) in patients with type 2 diabetes mellitus. METHODS: This study included 127 type 2 diabetic patients (males 63, females 64). The subjects were divided into two groups as with or without metabolic syndrome (MS(+) or MS(-)). The MS was diagnosed by International Diabetes Federation. Serum adiponectin, leptin, fasting plasma insulin, glucose, glycated hemoglobin, lipid profile, white blood corpuscle (WBC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid and C-reactive protein (CRP) were examined. RESULTS: Serum adiponectin concentrations were significantly lower in MS(+) than MS(-) (4.8 +/- 2.4 microgram/mL vs 7.6 +/- 5.8 microgram/mL, 7.6 +/- 3.7 microgram/mL vs 11.5 +/- 7.2 microgram/mL, P < 0.05 in males and females). After adjustment for age and body mass index (BMI), in MS (+), the serum levels of adiponectin correlated positively with high density lipoprotein - cholesterol (HDL-C) and negatively with height, body weight, ALT and CRP. In MS(-), the serum levels of adiponectin correlated positively with HDL-C and negatively with diastolic blood pressure (DBP), triglyceride and CRP. By multiple regression analysis, no parameters were independently correlated with serum adiponectin concentrations in MS(+), while DBP and HDL-C were independently related to serum adiponectin concentrations in MS(-). CONCLUSION: Serum adiponectin concentrations were lower in type 2 diabetic patients with MS than without MS. There were no significant parameters related to decrease serum adiponectin concentrations in MS. But further study is needed to confirm this result.

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Urinary adiponectin concentration is positively associated with micro- and macro-vascular complications
Won Seon Jeon, Ji Woo Park, Namseok Lee, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Cheol-Young Park, Byung-Soo Youn
Cardiovascular Diabetology.2013;[Epub] CrossRef
Association of Plasma Osteoprotegerin with Adiponectin and Difference according to Obesity in Men with Metabolic Syndrome
Woori Na, Cheongmin Sohn
Korean Journal of Community Nutrition.2011; 16(6): 762. CrossRef
The Effects of 12-Weeks Intensive Intervention Program on Cardiovascular Risk Factors, Adipocytokines and Nutrients Intakes in Industrial Male Workers
Kieun Moon, Ill Keun Park, Yeon Sang Jo, Yun Kyun Chang, Yun Mi Paek, Tae In Choi
The Korean Journal of Nutrition.2011; 44(4): 292. CrossRef
Relationship between Nutrients Intakes, Dietary Quality, and Serum Concentrations of Inflammatory Markers in Metabolic Syndrome Patients
Misung Kim, Juyoung Kim, Wookyung Bae, Sohye Kim, Yesong Lee, Woori Na, Cheongmin Sohn
Korean Journal of Community Nutrition.2011; 16(1): 51. CrossRef
Prevalence of Pancreatic Cancer in Diabetics and Clinical Characteristics of Diabetes-associated with Pancreatic Cancer - Comparison between Diabetes with and without Pancreatic Cancer -
Seung Goun Hong, Jae Seon Kim, Sung Joo Jung, Moon Kyung Joo, Beom Jae Lee, Jong Eun Yeon, Jong-Jae Park, Kwan Soo Byun, Young-Tae Bak
The Korean Journal of Gastroenterology.2009; 54(3): 167. CrossRef

Prevention of Diabetes by Fenofibrate in OLETF Rats: Hepatic Mechanism for Reducing Visceral Adiposity.: Hye Jeong Lee, Mi Kyoung Park, Kyung Il Lee, Young Jun An, Ji Min Kim, Ja Young Park, Young Han, Sook Hee Hong, Sun Seob Choi, Young Hyun Yoo, Joon Duk Suh, Duk Kyu Kim; Korean Diabetes J. 2007;31(1):63-74. Published online January 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.1.63

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Abstract PDF

BACKGROUND
The aim of this study is to evaluate the hepatic mechanism of fenofibrate that has the diabetes protective action in rats. METHODS: We chose OLETF rats and divided them into three groups. Fenofibrate (DF) group was fed with diet and fenofibrate (300 mg/kg/day). Paired feeding (Dd) group and free diet (DD) group were fed with diet. After 36 weeks of treatment, all the rats were sacrificed. RESULTS: The fasting blood glucose level of DF group (8.5 +/- 0.9 mmol/L) showed normal. The fasting blood glucose level of Dd group (22.4 +/- 3.0 mmol/L) and DD group (16.9 +/- 3.7 mmol/L) showed significantly increased than that of DF group (P < 0.01, respectively). The body weight, visceral adipose tissue and subcutaneous adipose tissue of DF group were significantly decreased compared to those of Dd and DD groups (P < 0.01, P < 0.05, P < 0.05). DF group showed significantly increased state-3 respiration rate, ATP synthetic activity, state-4 respiration rate and their blood beta-keton body levels than those of control groups (P < 0.01, respectively). DF group showed normal morphology of hepatocytes but DD and Dd groups showed hepatic steatosis with mitochondrial swellings. CONCLUSION: Chronic fenofibrate treatment prevents the development of diabetes in OLETF rats with inhibiting gain of body weight and abdominal adiposity. The hepatic mechanism for reducing visceral adiposity is that fenofibrate leads to increasing oxidative phosphorylation, uncoupling and ketogenesis as well as increasing beta-oxidation of fatty acids. Moreover, fenofibrate treatment prevents the development of hepatic steatosis.

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The Differences of Metabolic Syndrome Risk Factors according to Obesity and Abdominal Obesity in Elderly Korean Women
Kyung-A Shin
The Korean Journal of Clinical Laboratory Science.2016; 48(4): 304. CrossRef
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Jae-Joon Lee, Ah-Ra Kim, Hae-Choon Chang, Hae-Ok Jung, Myung-Yul Lee
Journal of the Korean Society of Food Science and Nutrition.2012; 41(8): 1086. CrossRef
Comparative analysis of fat and muscle proteins in fenofibratefed type II diabetic OLETF rats: the fenofibrate-dependent expression of PEBP or C11orf59 protein
Jong-Ryeal Hahm, Jin-Sook Ahn, Hae-Sook Noh, Seon-Mi Baek, Ji-Hye Ha, Tae-Sik Jung, Yong-Jun An, Duk-Kyu Kim, Deok-Ryong Kim
BMB Reports .2010; 43(5): 337. CrossRef
Comparative analysis of fat and muscle proteins in fenofibratefed type II diabetic OLETF rats: the fenofibrate-dependent expression of PEBP or C11orf59 protein
Jong-Ryeal Hahm, Jin-Sook Ahn, Hae-Sook Noh, Seon-Mi Baek, Ji-Hye Ha, Tae-Sik Jung, Yong-Jun An, Duk-Kyu Kim, Deok-Ryong Kim
BMB Reports.2010; 43(5): 337. CrossRef

Prevalence of Metabolic Syndrome in Type 2 DM Patients with Non-alcoholic Fatty Liver.: Ji Min Kim, Ja Young Park, Hyn Kyung Nam, Ja Won Kim, Su Kyung Park, Kyung Jin Nam, Mi Kyoung Park, Hye Jeong Lee, Duk Kyu Kim; Korean Diabetes J. 2006;30(6):442-449. Published online November 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.6.442

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Abstract PDF

BACKGROUND
Non-alcoholic fatty liver is rendered as one component of metabolic syndrome (MS). We evaluated the prevalence of MS as well as clinical and laboratory characteristics of Type 2 DM patients with non-alcoholic fatty liver. METHODS: Fatty liver group (n = 71) who showed significant fatty change by ultrasonography and age, sex matched control group (n = 40) were studied retrospectively. We compared demographic and laboratory findings and prevalence of MS by modified WHO criteria and new IDF criteria between both groups. RESULTS: There were no significant difference in age, DM duration, BMI, prevalence of hypertension, coronary artery disease, CVA, diabetic retinopathy, neuropathy, nephropathy between both groups. In fatty liver group, the plasma level of FBS, TG, ALT, total protein, albumin and GGT were significantly higher than those of control group (P = 0.033, P = 0.000, P = 0.002, P = 0.008, P = 0.003, P = 0.001). The plasma levels of HDL-C in fatty liver group were significantly lower than those of control group (P = 0.013). The plasma level of FBS, FFA, TG, total protein, albumin, ALT, HOMA(IR) and BMI were significantly related to the severity of fatty liver. The prevalence of MS in fatty liver group was significantly higher than that of control group by modified WHO criteria (P = 0.001) or new IDF criteria (P = 0.036). CONCLUSION: Type 2 DM patients with nonalcoholic fatty liver frequently accompanied the metabolic syndrome. They showed nonspecific changes in the liver function tests.

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Cardio-Metabolic Features of Type 2 Diabetes Subjects Discordant in the Diagnosis of Metabolic Syndrome
Sa Rah Lee, Ying Han, Ja Won Kim, Ja Young Park, Ji Min Kim, Sunghwan Suh, Mi-Kyoung Park, Hye-Jeong Lee, Duk Kyu Kim
Diabetes & Metabolism Journal.2012; 36(5): 357. CrossRef
Metabolic Syndrome and Serum Alanine Aminotransferase Levels in Korean Adults : The Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005.
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Exercise and Fenofibrate Reduces Body Adiposity Synergistically in OLETF Rats.: Young Jun An, Hre Jeong Lee, Mi Kyoung Park, Kyung Il Lee, In Young Koh, Dong Sik Jung, Ah Young Kang, Duk Kyu Kim; Korean Diabetes J. 2004;28(2):131-138. Published online April 1, 2004

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Abstract PDF: BACKGROUND
The PPAR alpha activator, Fenofibrate, is a pharmacological ligand, which induces beta-oxidation of long chain fatty acids in the mitochondria of hepatocytes. The beta-oxidation induced by exogenous PPAR alpha activators may be operated maximally when the sustained production of energy substrate in the liver is required by working muscles due to continued exercise. The aim of this study was to determine whether the combination therapy of exercise and Fenofibrate could synergistically reduce body adiposity in OLETF rats. METHODS: Twenty-eight male OLETF rats(13 wk old) were divided into four groups. The diet(n=7) and exercise groups(n=7) were fed with chow for 12 weeks. The Fenofibrate(n=7) and combined treatment(exercise and Fenofibrate) groups (n=7) were fed with Fenofibrate(32mg/kg/day) mixed chow for 12 weeks. The animals in the exercise and combined treatment groups were exercised by running on a treadmill for 12 weeks. At 24 weeks of age, all the rats were sacrificed, and examined by biochemical tests and had their adipose tissue weight measured. RESULTS: There were no significant changes in the retroperitoneal and subcutaneous fats between the diet and Fenofibrate groups, but there were between the diet and combined treatment groups(P<0.05). CONCLUSION: Exercise combined with Fenofibrate synergistically reduces body adiposity in OLETF rats

The Efficiency of Routine 99mTc-MIBI Myocardial SPECT for Detecting Silent IHD in Type 2 Diabetic Patients.: Duk Kyu Kim, Mi Kyoung Park, Do Young Kang; Korean Diabetes J. 2001;25(4):297-306. Published online August 1, 2001

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Abstract PDF: No abstract available.

Diastolic Dysfunction of Left Ventricle by Cardiovascular Autonomic Neuropathy in Type 2 Diabetic Patients Without Cardiovascular Symptom.: Duk Kyu Kim, Mi Kyoung Park, Do Young Kang; Korean Diabetes J. 2001;25(3):230-239. Published online June 1, 2001

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Abstract PDF: BACKGROUND
We investigated the effect of cardiovascular autonomic neuropathy for left ventricular function in cardiovascular symptom-free type 2 diabetic patients without other major risk factors known to cause cardiac dysfunction, especially diastolic dysfunction. METHODS: Forty seven patients (M:F=20:27, 53+/-10 years) with type 2 DM were enrolled in this study. None of the subjects had the macrovascular diabetic complications, hypertension, hypertrophic cardiomyopathy, valvular heart disease, alcoholic heart disease, congenital heart disease and older age (> 65 years). The patients were tested for cardiovascular autonomic neuropathy using five non-invasive tests of autonomic function. The response to each test was graded as 0, 0.5, 1. A patient was classified as having definite cardiovascular autonomic neuropathy if total score was 2 or more. Using these criteria, 26 patients (Group A) were determined to have cardiovascular autonomic neuropathy. Others were 21 patients (Group B). Tc-99 m RBC gated blood pool scintigraphy was performed as routine standard protocol. RESULTS: The degree of age, sex, body mass index (BMI), duration of diabetes, level of insulin, C-peptide, fructosamine, fasting plasma glucose, total cholesterol (TC), triglyceride (TG), HDL, LDL, BUN, creatinine and incidence of retinopathy, microalbuminuria were not different between group A and B. Heart rate response to Valsalva maneuver, heart rate response to standing were different between Group A and B (p=0.008, p=0.001, respectively). Ejection fraction of left ventricle were normal (> 50%) in all of patients. Maximal filling rate, average filling rate, maximal ejection rate and average ejection rate were increased in patients with cardiac autonomic neuropathy (p=0.03, p=0.05, p=0.02, p=0.04, respectively). Total score of autonomic function was significantly correlated with maximal filling rate (r=0.38, p=0.01), with average filling rate (r=0.37, p=0.01) and with maximal ejection rate (r=0.37, p=0.01). Maximal filling rate was most correlated with resting pulse (r=0.58, p<0.01). CONCLUSION: Cardiovascular autonomic neuropathy as single factor may result in diastolic dysfunction of left ventricle in cardiovascular symptom-free type 2 diabetic patients without other major factor known to cause cardiac diastolic dysfunction.

Randomized Controlled Trial

The Effect of Micronized Fenofibrate on the Plasma Levels of Glycated LDL-C, Lp(a) and Insulin Resistance in Patients with Type 2 Diabetes Mellitus.: Mi Kyoung Park, Duk Kyu Kim; Korean Diabetes J. 2000;24(6):678-688. Published online January 1, 2001

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Abstract PDF: BACKGROUND
It has been indicated that micronized fenofibrate therapy changes the atherogenic lipid profile into more favorable lipid profile in patients with type 2 diabetes and dyslipidemia. The aim of this study is to evaluate the effect of micronized fenofibrate on the plasma levels of glycated LDL-C, Lp(a), FFA and insulin resistance in patients with type 2 diabetes and dyslipidemia. METHODS: Forty-seven patients with type 2 diabetes (M/F=23/24, mean age 57 +/- 7 yrs) were studied who had relatively good glycemic index (HbA1c < 8.0%) but dyslipidemia (i.e., dyslipidemia : TG >2.25 mmol/L or HDL-C < 0.90 mmol/L or LDL-C >3.36 mmol/L). All the patients were maintained by the previous method of glucose control without change during entire period of the study. The patients were randomized to drug group (Lipidil ) or placebo group for 12 weeks and measured for fasting plasma levels of lipid, glycated LDL-C, Lp(a), insulin, C-peptide, glucose. The results were compared before and after the administration. RESULTS: Micronized fenofibrate therapy significantly reduced the plasma levels of triglyceride, total cholesterol, LDL-C, TC/HDL-C (p<0.0001), FFA (p<0.05) and ele vated the level of HDL-C (p<0.0001) after 12 weeks administration. However, no significant(-3.6%) changes were observed in the level of Lp(a) . In both groups, the plasma levels of glycated LDL-C were elevated even though the glycemic controls were good (drug group: 0.09+/-0.05 mmol/L, placebo group: 0.10+/-0.03 mmol/L), but no significant changes were noticed after administration for 12 weeks (-13.5%, +4.8%, respectively). HOMA-IR index was significantly decreased in the drug group after administration (p<0.01). The change of plasma insulin level was significantly different when compared to that of the placebo group (p<0.05). The plasma level of C-peptide and glycemic indexes (FBS and HbA1c) were not changed significant. CONCLUSION: Micronized fenofibrate therapy for 12 weeks was very effective for control of diabetic dyslipidemia. It significantly reduced FFA to improve the insulin resistance, but it didn't improve the elevated plasma level of glycated LDL-C and Lp(a).

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