Comparison between duration dependent effects of Simvastatin and Gemfibrozil on dyslipidemia in patients with type 2 diabetes.

Objective: To observe the duration dependent effects of two important classes of lipid lowering drugs i.e. simvastatin and gemfibrozil in type 2 diabetic patients with dyslipidemia in Pakistani population.

Methods: Seventy type 2 diabetic patients with newly diagnosed dyslipidemia were enrolled and were divided randomly into two groups each, with 35 patients. Group I patients was given tablets Simvastatin 20 mg once daily and group II patients received tablet Gemfibrozil 600 mg twice daily. The study period comprised of 12 weeks. Fasting lipid profile and fasting blood sugar was analyzed on week 0 (day of inclusion), week 6 and week 12.

Results: At week 12 simvastatin decreased serum LDL cholesterol by 36.97 percent (P < 0.001). In contrast gemfibrozil did not reduce it significantly with a reduction of only 1.33 percent (P = N.S). Simvastatin reduced serum total cholesterol and serum triglyceride by 29.88 percent (P < 0.001) and 21.78 percent (P < 0.001) respectively and increased serum HDL cholesterol by 16.67 percent (P < 0.001). While gemfibrozil decreased serum total cholesterol by 9.14 percent (P < 0.001) and serum triglyceride by 30.84 percent (P < 0.001). Gemfibrozil raised serum HDL cholesterol levels by 18.08 percent (P < 0.001).

Conclusion: Significant changes were observed in all lipid parameters with both simvastatin and gemfibrozil with regard to duration of treatment. Simvastatin was found to be more effective in lowering serum total cholesterol and LDL cholesterol levels in comparison to gemfibrozil, which was found to be more effective in lowering serum triglyceride and elevating serum HDL cholesterol levels. Both of these drugs were well tolerated and none of the patients exhibited any significant adverse effects. Both can be given as monotherapy in patients with type 2 diabetes mellitus and abnormal lipid profile.