Treating lipid abnormalities in patients with type 2 diabetes mellitus

The typical lipid levels in type 2 diabetes mellitus are low high-density lipoprotein cholesterol, normal low-density lipoprotein cholesterol, and high triglycerides. Atherosclerotic cardiovascular disease is the most common problem confronting those with type 2 diabetes mellitus. Some previous large lipid-lowering clinical trials conducted subanalyses of individuals with type 2 diabetes. Although these trials suggested a coronary benefit, questions remained because of (1) the limitations of such subanalyses, (2) the atypical characteristics of the populations, and (3) some inconsistencies in their findings. The Diabetes Atherosclerosis Intervention Study (DAIS), a randomized, double-blind, placebo-controlled study in men and women with type 2 diabetes, has demonstrated by quantitative angiography that treatment with micronized fenofibrate corrected their lipid abnormalities and reduced the progression of coronary disease. Furthermore, this occurred in individuals with lipid levels that many physicians would consider to be normal.