[Effect of antilipemic therapy on patients with diabetes mellitus and obesity].

Fibrates are hypolipemic agents used in noninsulin dependent diabetes mellitus (NIDDM) because these drugs have no influence on glycemia control. The efficiency of fenofibrate (Lipanthyl) was studied in a group of 22 subjects, 30-70 years, obese (body mass index-BMI over 30 kg/m2) or overweight (BMI = 28-30 kg/m2) with hypertension or/and diabetes. All the patients received 200 mg fenofibrate daily, for 6 month, and they had a hypocaloric diet. We measured seric lipids. The results were compared with a control group (20 normal subjects). Under treatment, atherogenic lipids (total cholesterol, LDL-cholesterol and triglycerides) had significantly decreased (p < 0.05) and antiatherogenic fraction (HDL-cholesterol) significantly increased (p < 0.05) compared to initial values. In the mean time, the BMI has significantly decreased under fenofibrate treatment, this body mass loss having a positive influence on lipid metabolism. We observed a better therapeutically response in obese patients vs. the overweight ones, probably due to a higher prevalence of the hypertension in the second subgroup. In conclusion fenofibrate is the drug which can be choose in diabetic dyslipidemia without cardiac disease.