Utah study may help diabetics

Diabetic patients who have not been able to control their cholesterol despite medication may benefit from a new study by heart researchers at LDS Hospital.

Their findings will be presented today to the American College of Cardiology scientific session in Atlanta.

The researchers discovered that diabetic patients who were already taking two cholesterol-lowering drugs to reduce LDL cholesterol and triglycerides without achieving the recommended levels saw dramatic improvement when they added a third, specific cholesterol-lowering drug. High cholesterol levels have been linked to heart disease, a common and life-threatening complication of diabetes.

It's the first study to show the effects of triple-drug therapy on cholesterol in patients with Type 2 diabetes. But Dr. Brent Muhlestein, one of the study authors and director of cardiovascular research at LDS Hospital, says the finding is potentially significant for anyone who has been unable to reach cholesterol target levels, whether they have diabetes or not.

Best of all, Muhlestein says, the study subjects reached their target cholesterol levels without additional side effects or adverse reactions.

Dual-drug therapy using statin drugs is a common prescription for people with elevated cholesterol. Even then, though, most fall short of the guidelines set by the National Cholesterol Educational Program. Those guidelines call for LDL "bad" cholesterol levels below 100 mg/dL, HDL or "good" cholesterol levels above 40 mg/dL and triglyceride levels below 150 mg/dL.

While dual-drug therapy undoubtedly helps, it's simply not enough for some, says Muhlestein.

The use of triple-drug therapy has been used with other conditions, including high blood pressure. Using multiple drugs also allows doctors to prescribe lower doses and avoid side effects that can be associated with higher doses.

All the study patients received dual therapy with simvastatin and fenofibrate, which both slow down production of cholesterol and triglycerides in the liver. They were also randomized to receive either ezetimibe or a placebo.

Muhlestein says ezetimibe works differently, operating in the digestive tract to help block absorption of cholesterol from food or bile. It blocks an active transporter of cholesterol by about 85 percent .