23 may 2009 -- The chances of having to have a limb amputated because of diabetes were reduced by 36 percent when people with type 2 diabetes were given the drug fenofibrate to lower their blood fat levels, new research has found.
The study included 9,795 people, ages 50 to 75, who took either 200 milligrams of fenofibrate or a placebo daily for five years. The researchers reported that 115 people had lower-limb amputations attributed to diabetes.
People with previous cardiovascular disease, microvascular disease, previous non-traumatic amputation or skin ulcer, smoking and a longer duration of diabetes were more likely to have amputations than those who had other cardiovascular problems or those who had neither cardiovascular issues or amputations.
The risk of a first amputation was 36 percent lower among people taking fenofibrate than those taking the placebo. The study also found that people in the fenofibrate group had a 47 percent lower risk of amputations below the ankle and without large-vessel disease in the amputated limb. The researchers considered the status of large-vessel disease to distinguish amputations related to large-artery atherosclerosis from those related to diabetic microvascular disease.
The study found virtually no difference in the risk for amputations above the ankle between those who did and did not take fenofibrate.
Height was found to be a major predictor of amputations, with a 1.6-fold increase for every additional 10 centimeters in height.
"Classic markers of macrovascular and microvascular risk were associated with lower-extremity amputations in patients with type 2 diabetes," concluded Professor Anthony Keech, of the National Health and Medical Research CouncilClinical Trials Centre at the University of Sydney, in Australia, and his colleagues.
"These findings could lead to a change in standard treatment for the prevention of diabetes-related lower-limb amputations," they concluded, adding that the results "showed a reduction in amputation rates that seemed to emerge after just 1.5 years of fenofibrate use."
The study was published this week in a special issue of The Lancet devoted to diabetes.