Effects of bezafibrate on insulin sensitivity and insulin secretion in non-obese Japanese type 2 diabetic patients

The aim of the present study was to investigate the effect of bezafibrate on insulin sensitivity and insulin secretion in 30 non-obese Japanese type 2 diabetic patients with hypertriglyceridemia (serum triglycerides > 150 mg/dL). Insulin sensitivity was measured with homeostasis model assessment insulin resistance (HOMA-IR) proposed by Matthews et at. HOMA-B-cell function, proposed by Matthews et al validated against minimal model-derived insulin secretion, was used to assess pancreatic insulin function. Twenty-two patients were treated with glibenclimide and the rest were treated with diet alone. All patients were treated with bezafibrate (400 mg/d) for 3 months. There were no changes in diet and the dose of any medications used throughout the study. Fasting glucose, insulin, triglycerides, HDL cholesterol, and total cholesterol levels were measured before and after treatment of bezafibrate. After treatment of bezafibrate for 3 months, serum triglyceride levels significantly decreased from 277 +/- 30 to 139 +/- 9 mg/dL (P < .001) and serum HDL cholesterol levels increased significantly from 45 <plus/minus> 2 to 52 +/- 2 mg/dL (P = .003). Serum cholesterol level was unchanged during the study (198 +/- 7 v 201 +/- 7 mg/dL, P = .383). Fasting glucose (163 +/- 8 v 139 +/- 6 mg/dL, P = .006) significantly decreased after the treatment with bezafibrate. HbA1c levels decreased, although not statistically significant (7.50 +/- 0.25 v 7.17% +/- 0.19%, P = .147). On the other hand, fasting insulin (9.3 +/- 0.7 v 7.3 +/- 0.5 muU/mL, P = .010) and HOMA-IR (3.61 +/- 0.24 to 2.53 +/- 0.20, P < .001) levels decreased significantly after the treatment with bezafibrate. In contrast, HOMA-B-cell function did not change during the study (41.4 <plus/minus> 5.5 v 41.8 +/- 4.7, P = .478). There was no significant difference in body mass index (BMI) levels before and after the therapy (23.0 +/- 0.4 v 23.1 +/- 0.4 kg/m(2), P = .483). From these results, it can be concluded that bezafibrate reduces serum tiglycerides, insulin resistance, and fasting blood glucose levels in non-obese Japanese type 2 diabetic patients. Copyright (C) 2001 by W.B. Saunders Company.