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Background: Hyperlipidemia in NIDDM patients is a major risk factor of atherogenesis, and its proper management is an important issue to decrease the mortality due to macrovascular complications. Acipimox, newly developed nicotinic acid derivative, is known to have safe and long-lasting antilipolytic activity. The purpose of this study was to evaluate the effects of acipimox on lipid and glucose metabolism in hyperlipidemic patients with NIDDM. Methods : The effects of acipimox treatment were evaluated on the changes of lipid and glucose metabolism after 8 weeks of administration, and its side effects were also evaluated in 24 hyperlipidemic patients with NIDDM. Results : 1) Serum cholesterol concentration was decreased and HDL cholesterol concentration was increased significantly after acipimox treatment. Serum triglyceride concentration was also decreased without statistical significance following acipimox administration. 2) Fasting serum glucose level was significantly decreased, but postprandial glucose and glycated hemoglobin levels were not changed significantly after acipimox treatment. 3) Serum free fatty acid level was significantly decrease after acipimox treatment. 4) Serum Apo AI level was increased, and Apo B and lipoprotein (a) levels were decreased significantly following treatment. 5) Among 24 patients, we could not find any other side effects except mild and transient pruritus in one patient. Conclusion : Acipimox is thought to be an effective and safe drug for the treatment of hyperlipidemia in patients with non insulin-dependent diabetes mellitus.