Cholesterol and Glycemic Effects of Niaspan in Patients with Type 2 Diabetes

Study Objective. To determine the effect of Niaspan—a niacin preparation with both immediate‐ and extended‐release characteristics—on lipid and glycemic control in patients with type 2 diabetes. Design. Retrospective study. Setting. Private‐practice endocrinology group. Patients. Thirty‐two patients (mean age 60 yrs; 72% men) with type 2 diabetes identified by a computerized text search. Intervention. Patients received Niaspan 1000, 1500, or 2000 mg/day (median daily dosage 1000 mg). Measurements and Main Results. Total cholesterol, low‐density lipoprotein (LDL) cholesterol, high‐density lipoprotein (HDL) cholesterol, triglycerides, hemoglobin A1c, and transaminase levels were compared for each patient before and 6 months after initiation of Niaspan. Niaspan therapy was associated with a significant 34% increase in HDL (p=0.033), a significant 36% reduction of triglycerides (p=0.049), and no significant change in LDL (p=0.236) or total cholesterol (p=0.122). Mean hemoglobin A1c levels significantly decreased from baseline by 0.5 ± 0.3% (p=0.032), even though dosages and treatment with antidiabetic agents remained constant. There were no significant changes in transaminase levels. Seven patients (21.9%) discontinued Niaspan; one of them experienced an increase in blood glucose while receiving the agent. Conclusion. For most patients with type 2 diabetes, Niaspan is a safe and effective therapy for dyslipidemia and does not exacerbate glycemic control.