Association between extended-release niacin treatment and glycemic control in patients with type 2 diabetes mellitus: analysis of an administrative-claims database

Abstract

The aim of the study was to evaluate trends in antihyperglycemic agents (AHAs) use in patients with type 2 diabetes mellitus (T2DM) newly initiating extended-release niacin (ERN) compared with other lipid-modifying therapy (LMT). United States administrative-claims data identified adults with T2DM on AHAs who received a new prescription for ERN or another LMT between January 2001 and June 2003 (index date), and these adults were followed for 12 months. Inclusion criteria were (1) stable T2DM as defined by International Classification of Diseases, Ninth Revision, codes and also receiving at least 2 AHA prescriptions 12 to 24 months before initiating ERN or LMT treatment and (2) at least 2 prescriptions within 12 months before the onset of ERN or LMT. Trends in AHA prescriptions 12 months before (baseline) and after (follow-up) index date were defined as (1) no change (ie, stable T2DM), (2) increased (ie, worsening T2DM), or (3) reduced (ie, improved T2DM). Among 3799 patients with T2DM, 392 (10.3%) were treated with ERN and 3407 (89.7%) were treated with other LMT. In the ERN cohort, 82.1% of patients experienced no change in AHA prescriptions between baseline and follow-up compared with 79.4% of patients in the LMT cohort ( P = .20); 13% of the ERN cohort and 16% of the LMT cohort ( P = .17) experienced a dose increase or the addition of another AHA; and 5% of both cohorts were prescribed fewer AHAs or switched to a lower dose ( P = .92). Treatment with ERN (vs other types of LMT) did not significantly increase AHA use, implying that T2DM status did not worsen in this cohort.