Issue 116 Item 8 Niacin Is An Effective Therapy For Diabetes Dyslipidemias

Niacin is an effective therapy for treating a broad range of atherogenic dyslipidemias in many patients with diabetes. Researchers at the Diabetes Research Center, in Tustin, California and the University of California, Irvine in the United States conducted a study of 42 diabetic patients with abnormal blood lipid profiles, who were treated with niacin.

Before and after treatment, they measured the patients’ serum triglycerides, small, dense low density lipoprotein cholesterol (LDLc) particle mass, LDL particle size, total high density lipoprotein C (HDLc) and high density lipoprotein 2 (HDL2) percentage, and lipoprotein(a) [LP(a)].

After niacin treatment, the patients’ LDL peak particle diameter increased from 252 ± 7 Å to 263 ± 7, the researchers reported. Their small, dense LDLc particle mass decreased from 27 ± 11 mg/dL to 15 ± 4 mg/dL. Total HDLc increased from 39 ± 7 mg/dL to 51 ± 11 mg/dL. Their HDL2, as the percentage of total HDLc mass, increased from 29 ± 8 percent to 45 ± 10 percent, and their Lp(a) decreased from 43 ± 17 mg/dL to 25 ± 10 mg/dL.

With the use of increased oral therapy and insulin doses in more than 90 percent of patients, their mean hemoglobin A1c level improved from 7.6 ± 1.8 percent to 6.5 ± 1.0 percent.

Twenty-one percent of the patients were unable to tolerate niacin because of reversible adverse effects. Another 14 percent were unable to adhere to the niacin dosing regimen of three times daily, the authors reported.

Based on these findings, niacin is an effective therapy for a broad range of diabetic dyslipidemias associated with both the atherogenic lipid profile and Lp(a). However, it must be used with modern and aggressive oral hypoglycemic agents or insulin treatment, the researchers concluded. Diabetes Obes Metab 2002; 4: 255-261