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Dyslipidemia in patients with type 2 diabetes typically includes increased serum-triglyceride and decreased HDL-cholesterol levels. Fibrates improve these lipid abnormalities but have not, like statins, been shown to prevent cardiovascular morbidity in diabetics.
With industry funding, investigators randomized 9795 diabetics who were not on lipid-lowering therapy (total cholesterol level 116–250 mg/dL, with plasma triglyceride level 90–440 mg/dL or a total-to-HDL–cholesterol ratio ≥4.0) to receive either micronized fenofibrate (200 mg daily) or placebo. During a median 5 years of follow-up, patients randomized to fenofibrate had a nonsignificant 11% relative reduction in the primary outcome of first myocardial infarction or coronary death, i…