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A class of drugs that effectively lowers triglyceride levels and raises levels of “good” high-density lipoprotein (HDL) cholesterol levels. They are not very effective for lowering “bad” low-density lipoprotein (LDL) cholesterol levels. Fibrates (also called fibric acid derivatives) include fenofibrate (brand name TriCor) and gemfibrozil (Lopid).

Type 2 diabetes is associated with a twofold to fourfold excess risk of cardiovascular disease. While total cholesterol and LDL cholesterol levels in people with Type 2 diabetes are similar to or lower than those of people who don’t have diabetes, people with Type 2 diabetes tend to have higher blood triglyceride levels and decreased levels of HDL cholesterol, which could contribute to their high risk of cardiovascular disease.

According to the American Diabetes Association, the first priority in treating abnormal cholesterol and triglyceride levels in people with Type 2 diabetes should be lowering high LDL cholesterol levels, preferably with a class of lipid-lowering drugs called HMG CoA reductase inhibitors (or “statins”). Fibrates should be used specifically to lower triglyceride levels and raise HDL levels, and they are often used in combination with a statin.

A clinical trial called the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study, published in the journal The Lancet in 2005, showed that fenofibrate reduced the risk of cardiovascular events – namely, cardiovascular death, heart attack, stroke, and coronary and carotid artery revascularization procedures – in people with diabetes.

Originally Published October 29, 2009

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