Extended-Release Niacin Safe for Diabetics W/ Hypercholesterolemia
There has been some concern in the past with regards to the safety of using niacin with diabetics. This study evaluated a 1 and 1.5 gram dose of extended release niacin in diabetics. These dosages of typically much lower than has been used in other studies (typically 2-3 grams are used); however, these patients were already on additional cholesterol-lowering medications and this may be the reason for the lower dose used. Overall, the results were favorable, with the 1.5 gram dose having some effect on glycemic control. Both dosages were very effective in increasing HDL levels.
50th Annual Scientific Session of the American College of Cardiology Diabetics with poorly controlled cholesterol levels despite statin therapy can be safely given extended-release niacin. The combination significantly improves the lipid profile without adversely affecting glycemic control, Texas researchers reported . In the past, niacin has been shown to worsen glycemic control in diabetics, Dr. Gloria L. Vega of the University of Texas Southwestern Medical Center in Dallas said, even though niacin corrects the lipid abnormalities typically seen in diabetes. In her presentation to conference attendees, Dr. Vega described how she and her colleagues tested extended-release niacin (Niaspan, Kos Pharmaceuticals, Miami) in 148 diabetics with abnormal lipid profiles, many on statin therapy, in a 16-week trial. The researchers compared the effects of 1 gm and 1.5 gm extended-release niacin with placebo. Dr. Vega reported that 1 gm extended-release niacin increased high-density lipoprotein cholesterol levels 19% and 1.5 gm increased them 24%, while placebo had no significant effect. Levels of low-density lipoprotein cholesterol did not change significantly with either placebo or 1 gm niacin, while they dropped 8% with the 1.5 gm dose. Triglyceride levels dropped 24% and 29% for patients on 1 gm and 1.5 gm extended-release niacin, respectively. Fasting blood glucose and hemoglobin A1c levels did not change during the study in the placebo and 1 gm arms of the study, but patients on 1.5 gm niacin had a worsening of glycemic control. “We are very excited about this study,” Dr. Vega told Reuters Health. “Extended-release niacin can be incorporated into the treatment regimen of diabetics….It can be used with statin therapy or triglyceride-lowering drugs….There was no increase in liver enzymes and no increased weakness” during the study period, she added. “Certainly you are not going to take a patient with poor glycemic control and try this,” Dr. Vega said. “But most physicians are not aware that niacin can effectively increase HDL….Niacin has a bad reputation in terms of glycemic control, but you can control that with drugs rather than discontinue the niacin,” she asserted.