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 A 1c , 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 A 1c 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.