March 6, 2005
Other Illnesses, Type 2
Question from Urbana, Ohio, USA:
Before starting Niaspan my blood test showed HDL-39, LDL-59, Total 132, triglycerides-normal range, A1c 6.9. After three months on 1000 mg of Niaspan, my blood test showed HDL-41, LDL-49, Total-112, triglycerides 108, A1c 7.3. My doctor increased my Niaspan to 2000 mg and my fasting blood sugar has increased 40 to 60 mg/dl [2.2 to 3.3 mmol/L] on average, even though he increased my metformin from 500 mg to 1500 mg per day.
I had five bypasses six years ago and take 40m g of Zocor as well as 2.5/10 mg Lotrel and 50 mg of Atenolol. I didn’t have a heart attack. Based on the blood tests before starting Niaspan, I think I should stop taking the Niaspan as I feel, at this point, that controlling my type 2 diabetes is more important. Am I correct? Previous blood test results have been almost the same since the bypass surgery.
Answer:
It is well known that niacin, the active ingredient in niaspan, induces insulin resistance. When the drug is used in patients with type 2 diabetes, there is always the concern that it will increase glucose levels. It will also decrease triglyceride levels and LDL-cholesterol levels. It will also increase HDL-cholesterol, as this is protective for atherosclerotic vascular disease. I would say that there was no marked increase in HDL-cholesterol, minimal decrease in triglyceride, and you had mostly down-side effects, in terms of your blood sugar. What you need to do is to talk with your physician and speak about these positive and negative effects and decide if it is best for you to stay on this medication.
JTL
