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Extended-Release Niacin Raises Fasting Glucose Levels

Transient increase; remits without intervention in ezetimibe/simvastatin-treated patients

WEDNESDAY, March 28 (HealthDay News) -- The combination of extended-release niacin (N) with ezetimibe plus simvastatin (E/S) to treat hyperlipidemia is associated with increased fasting glucose (FG) levels compared with E/S alone, but these cases tend to be transient and remit without intervention, according to research published in the April issue of Diabetes Care.

In an effort to determine whether extended-release niacin affected FG levels or the incidence of new-onset diabetes, John R. Guyton, M.D., of Duke University in Durham, N.C., and colleagues conducted a secondary analysis of data from 942 patients with hyperlipidemia treated for 64 weeks with either E/S or E/S plus extended-release niacin (E/S+N).

The researchers found that FG levels peaked by eight to 12 weeks and then declined even without use of antidiabetic therapies. At 64 weeks, the criteria for new onset diabetes was met by 3.5 percent of those taking E/S+N and 2.6 percent of those taking E/S (P = 0.66). The criteria for diabetes was transiently met by an additional 1.4 percent of those taking E/S+N versus 0.4 percent taking E/S, all of whom then remitted (P = 0.46). By 24 weeks, 25 of the 28 new diabetes diagnoses in the E/S+N group had occurred. In those with diabetes at baseline, antidiabetic treatment modification was undertaken by 13.9 percent of those taking E/S+N versus 11.6 percent taking E/S.

"In summary, combination E/S+N produced small initial increases in FG and new diagnoses of diabetes that dissipated over time, largely without the use of antidiabetic medication," the authors write.

The study was funded by Merck/Schering-Plough Pharmaceuticals; several authors disclosed financial ties to pharmaceutical companies, including Merck.

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