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NICOTINIC ACID WORSENS GLUCOSE CONTROL IN DIABETICS.

Hypercholesterolemia is common in diabetics, and nicotinic acid is often one of the first-line drugs used to bring cholesterol levels down. These data from 13 patients with non-insulin-dependent diabetes mellitus (NIDDM) demonstrate that while nicotinic acid is effective in reducing cholesterol, it may also carry certain disadvantages in this population.

In an unblinded randomized trial, the patients received either nicotinic acid (up to 1.5 g three times per day) or no therapy for 8 weeks, then crossed over to the alternate study group for another 8 weeks. Nicotinic acid had the expected beneficial effects on plasma lipids -- total cholesterol fell 24 percent, triglycerides fell 45 percent, low-density lipoprotein cholesterol fell 15 percent, and high-density lipoprotein cholesterol rose 34 percent. However, nicotinic acid was also associated with worsening glucose control, as evidenced by a 16 percent increase in mean plasma glucose levels and a 21 percent rise in glycosylated hemoglobin concentrations.

The authors conclude that nicotinic acid is not the best first choice for treatment of hyperlipidemias in patients with NIDDM.

— THL

Published in Journal Watch General Medicine August 21, 1990

Citation(s):

Garg A; Grundy SM. Nicotinic acid as therapy for dyslipidemia in non- insulin-dependent diabetes mellitus. JAMA 1990 Aug 8 264 723-726.

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