If you’re interested in diabetes and vascular biology you will love this paper. It has wonderful figures and tables. The interest in diabetes has escalated to enormous levels over the last decade. The basic science abnormalities have largely been focused around nitric oxide, free radical formation and HDL capacity. Sorrentino et al have completed research that goes to the heart of the diabetes HDL vascular biology with information on clinical importance of niacin. Sorrentino enrolled 10 healthy and 33 type 2 diabetes patients and completed in depth studies on important vascular biology areas. Patients with diabetes were randomized to a 3-month therapy with ER niacin (1500 mg/d) or placebo. Vascular biology testing of HDL included endothelial function testing, stimulated endothelial nitric oxide production, endothelial oxidant stress, and early endothelial progenitor cell–mediated endothelial repair. Results from the trial found that patients with type 2 diabetes when treated with ER niacin 1500/day increased HDL plasma level but more importantly the vascular biology test revealed improved endothelial function with increased NO production and reduced superoxide production by electron spin resonance spectroscopy analysis. Testing of endothelial progenitor cell mediated endothelial repair was significantly improved with niacin in type 2 diabetes patients. In summary, this study shows improved HDL number and function in type 2 diabetes patients beyond the HDL number. Robert J. Chilton, DO FACC