title: Effect of extended-release niacin on new-onset diabetes among hyperlipidemic patients treated with ezetimibe/simvastatin in a randomized controlled trial.
abstract: OBJECTIVE
  To determine the effect of niacin on fasting glucose (FG) and new-onset diabetes in statin/ezetimibe-treated patients.
  
  
  METHODS
  This was a prespecified secondary analysis among 942 hyperlipidemic patients randomized to ezetimibe/simvastatin (E/S; 10/20 mg) or E/S + extended-release niacin (N; titrated to 2 g) over 64 weeks.
  
  
  RESULTS
  FG levels peaked by 8-12 weeks, then declined even without antidiabetic medication. At 64 weeks, 3.5% taking E/S+N versus 2.6% taking E/S met criteria for new-onset diabetes (P = 0.66). An additional 1.4% taking E/S+N versus 0.4% taking E/S transiently met criteria for diabetes and then remitted (P = 0.46). Of 28 new-diabetes diagnoses in the E/S+N group, 25 occurred by 24 weeks. Among patients with baseline diabetes, 13.9% taking E/S+N and 11.6% taking E/S underwent antidiabetic treatment modification.
  
  
  CONCLUSIONS
  Increased FG and new-onset diabetes with E/S+N occurred mainly around the time of initial uptitration of N and often improved or remitted without specific treatment.
authors.affiliation: Department of Medicine, Division of Endocrinology, Duke University, Durham, North Carolina, USA. guyto001@mc.duke.edu
authors.forename: John R
authors.initials: JR
authors.lastname: Guyton
authors.forename: Sergio
authors.initials: S
authors.lastname: Fazio
authors.forename: Adeniyi J
authors.initials: AJ
authors.lastname: Adewale
authors.forename: Erin
authors.initials: E
authors.lastname: Jensen
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Tomassini
authors.forename: Arvind
authors.initials: A
authors.lastname: Shah
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Tershakovec
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001384:Azetidines / Q000008:administration & dosage*; D003692:Delayed-Action Preparations; D048909:Diabetes Complications / Q000188:drug therapy; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology; D004338:Drug Combinations; D000069499:Ezetimibe, Simvastatin Drug Combination; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000008:administration & dosage* / Q000494:pharmacology*; D019821:Simvastatin / Q000008:administration & dosage*; D013997:Time Factors; D055815:Young Adult
chemical_list: D001384:Azetidines; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D000069499:Ezetimibe, Simvastatin Drug Combination; D000960:Hypolipidemic Agents; D009525:Niacin; D019821:Simvastatin