Cholesterol and glycemic effects of Niaspan in patients with type 2 diabetes

Study Objective. To determine the effect of Niaspan-a niacin preparation wi th both immediate- and extended-release characteristics-on lipid and glycem ic 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 diabet es identified by a computerized text search. Intervention. Patients receive d 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 Al, and transaminase levels were compared for each patient bef ore and 6 months after initiation of Niaspan. Niaspan therapy was associate d with a significant 34% increase in HDL (p=0.033), a significant 36% reduc tion of triglycerides (p=0.049), and no significant change in LDL (p=0.236) or total cholesterol (p=0.122). Mean hemoglobin A,, levels significantly d ecreased from baseline by 0.5 +/- 0.3% (p=0.032), even though dosages and t reatment with antidiabetic agents remained constant. There were no signific ant changes in transaminase levels. Seven patients (21.9%) discontinued Nia span; 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 e ffective therapy for dyslipidemia and does not exacerbate glycemic control.