Preventing diabetic complications: a primary care perspective.

While controlling cardiometabolic risk factors remains central to diabetes management, substantial disease burden persists despite intensive targeting of blood glucose, blood pressure and lipids. Data from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study provide some new insights. As well as significant reduction in total cardiovascular disease events, especially among patients with marked atherogenic dyslipidaemia (low high-density lipoprotein (HDL) cholesterol and hypertriglyceridaemia), fenofibrate had preventive effects on microvascular outcomes, reducing laser treatment for retinopathy, progression of albuminuria, and non-traumatic amputations. These findings suggest re-evaluation of fenofibrate as an option for reducing the risk of diabetic vascular complications.