Concerns about niacin's possible adverse effects on glycemic control in people with diabetes have curtailed its use for modifying lipids in this group of patients, most of who also have lipid abnormalities. A multi-center clinical trial was undertaken to evaluate these concerns, and results were recently reported in the Journal of the American Medical Association.
The research showed that people with diabetes achieved very similar benefits as those without: niacin use increased HDL by 29% in both groups of patients, decreased triglycerides by 23% and 28%, respectively, and decreased LDL cholesterol by 8% and 9%, respectively. Glucose levels were modestly increased by niacin: 8.7 mg/dL in people with diabetes and 6.3 mg/dL in those without. Levels of HbA1c were unchanged in people with diabetes.
The authors concluded that lipid-modifying dosages of niacin can be safely used in patients with diabetes and that niacin therapy may be considered as an alternative to statin drugs or fibrates for patients with diabetes who do not tolerate these agents well or in whom they are not effective.
Source: Elam MB, Hunninghake DB, Davis KB, et al. Effect of niacin on lipid and lipoprotein levels and glycemic control in patients with diabetes and peripheral arterial disease. JAMA, 2000;284(1263-1270). Abs.