We were intrigued that the benefits reported in the FIELD study (Nov 17, p 1687)1 were independent of the a-priori postulated biological mechanism. A C Keech and colleagues hypothesised that fenofibrate would reduce retinopathy progression in patients with type 2 diabetes by lowering blood lipids. However, although fenofibrate reduced first laser therapy by 30%, this effect was not mediated by improved lipid, glycaemic, or blood pressure profiles. Keech and colleagues are unsure of the underlying mechanism of action.
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