Effects of bezafibrate on lipid and glucose metabolism in dyslipidemic patients with diabetes: the J-BENEFIT study

Background: The hypoglycemic effect of bezafibrate is well established, but administration to a large population of patients with diabetes has not been reported. We investigated glycemic control, relationship between lipid metabolism and HbA1c, and safety in diabetic patients treated with bezafibrate. Methods: A prospective, observational analysis was conducted on 6,407 dyslipidemic patients suffering from diabetes or hyperglycemia who had not received bezafibrate previously. Subanalyses were performed on the concomitant use of diabetes drugs, diabetes duration, and baseline HbA1c levels. Results: Bezafibrate significantly decreased HbA1c irrespective of concomitant use of other diabetes drugs in a baseline-HbA1c-dependent manner, with patients with a shorter diabetes duration showing a greater decrease in HbA1c than those with longer-term disease. The rate of change in triglyceride levels was significantly associated with that in HbA1c. Adverse drug reactions occurred in 306 patients (5.1%), of which reactions in 289 were not severe (94.4%). Conclusions: Bezafibrate significantly improved HbA1c in patients with diabetes given individualized treatment. Bezafibrate may offer clinicians an improved modality for the amelioration of disease course and improvement of outcome in these patients.