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Nicotinamide is a form of Vitamin B3 that may preserve and improve beta cell function. It has been used in diabetes treatment and prevention. Potential side effects include headache, skin and GI effects, exacerbation of gout and ulcers, as well as allergies. Liver and platelet function should be monitored. It may increase serum concentrations of the anticonvulsants, carbamazepine and primidone. A large population-based trial in New Zealand was conducted in high risk children. Islet cell antibodies (ICA) were measured in over 20,000 children. A total of 185 children had positive ICA levels indicating a higher risk for development of diabetes. Of these; 173 children received nicotinamide for an average follow up time of 7.1 years. Nicotinamide use decreased the incidence of diabetes by 60%. Another trial, the Deutsche Nicotinamide Intervention Study (DENIS), in 55 children at high risk for type 1 diabetes showed no major decrease of diabetes. The role of nicotinamide is unknown at this time and more may be known when the ENDIT (European Nicotinamide Diabetes Intervention Trial) is published.

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Laura Shane-McWhorter, PharmD, BCPS, FASCP, CDE, BC-ADM
November 24, 2001

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