The evidence often cited for this hands-off approach is an 8-week study of 13 patients with type 2 diabetes who received 4.5 g/day of a non-sustained-release form of nicotinic acid. These patients subsequently experienced a 21% increase in HbA1c.[20] Niacin-induced hyperglycemia is believed to be caused by an increase in insulin resistance.[12] It is conceivable that niacin dosage and/or product release characteristics might determine the hyperglycemic effects of the drug. With the exception of one patient, no glycemic deterioration occurred in our study, in which the median daily dose of Niaspan was 1000 mg.
Yes, worsening insulin resistance is a concern. However, recent studies have shown it to be effective in diabetics. Their Hba1c didn't rise. See medscape.com418319 4Open ↗
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From your source:
The evidence often cited for this hands-off approach is an 8-week study of 13 patients with type 2 diabetes who received 4.5 g/day of a non-sustained-release form of nicotinic acid. These patients subsequently experienced a 21% increase in HbA1c.[20] Niacin-induced hyperglycemia is believed to be caused by an increase in insulin resistance.[12] It is conceivable that niacin dosage and/or product release characteristics might determine the hyperglycemic effects of the drug. With the exception of one patient, no glycemic deterioration occurred in our study, in which the median daily dose of Niaspan was 1000 mg.
It seems to me I heard somewhere that Sharon Hope wrote in article <BRRqb.139499$Tr4.358422@attbi_s03>:
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"Don Kirkman" <[email hidden]> wrote in message news:[email hidden]...
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It seems to me I heard somewhere that Sharon Hope wrote in article <Zq7qb.80890$mZ5.546171@attbi_s54>:
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New drug heralded as a miracle drug for opening clogged arteries. Essentially, they ADDED cholesterol, the "good" HDL, to patients, and
their
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arteriosclerosis blockages quickly melted away.
[...]
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Beware getting too enthused about this at first, though. Suddenly the Lipitor cheerleaders are using the same unprofessional medical
superlatives
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about this drug as, "Astonishing", "Amazing", and "Holy Grail". These are exactly the same cast of characters who have made it their business to be sure that no honest studies that show negative effects of Lipitor or the other statins get published, or, if they slip through, they are instantly attacked and prefaced by journal editorials as 'flawed.' YMMV
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I notice, though, that the cheerleaders are media companies (Fox News?!), not scientists, or are you saying that Kaul S, Rukshin V, Santos R, Azarbal B, Bisgaier CL, Johansson J, Tsang VT, Chyu KY, Cercek B, Mirocha J, Shah PK, et.al., are using superlatives such as you cite? (And, yes, those are *UNPROFESSIONAL* medical superlatives, not medical ones.) IMO that's a major problem with the discussions on this newsgroup.
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Scott Grundy
Care to expand on who or what this means? -- Don [email hidden]
Dr Chaos <[email hidden]> wrote in news:[email hidden]:
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I'm not a doctor, but I think the study emphasizes the key role of raising HDL for the long run, and that the patient and doctor should manage HDL aggressively.
How does a study that lasted a few weeks show anything long term? I don't think your conclusions are supported by the study.
The conclusion supported by the study is that in the short term, supplementing HDL with an HDL like construct has a small effect on atheroma. We have no more knowledge about long term, nor about the body's own HDL.
And most importantly, we know nothing new about morbidity and mortality. It is possible that in a long term study the finding will be change in plaque volume but no change in morbidity and mortality. The compound then would be little more than a placebo for real outcomes.
I do think it illustrates that plaque is not biologically inactive, and can respond to the vascular environment.
These are the questions that came to my mind when I read the study. I often find that hearing/seeing science and medicine reported in the media generates more questions and provides precious little real information. I prefer to go to the source literature and do a critical evaluation, a very brief synopsis of the results are presented here.
So, back to you; if a patient hears/sees this in the media and asks you about it, what would you tell them?
I'm not a doctor, but I think the study emphasizes the key role of raising HDL for the long run, and that the patient and doctor should manage HDL aggressively.
Personally I got a multivitamin with extra niacin and will ask my GP about HDL testing.
I wish there was a way to boost HDL more efficiently with one med, because it seems to me that the only way to do so with medication is try and push the LDL down, and adding omega3 fatty acids hoping the HDL will go up. Niacin seems to be the winner here for focusing on the HDL however when working just with meds.
BTW, you can have your lipid profile drawn without a prescription. Insurance companies should reimburse people to do so a few times a year, but who said they were a logical group anyway.
You can a fairly complete profile and at reasonable cost. I use healthcheckusa.com. Works everywhere but California, where the state health bozos have decided your bodily fluids don't belong to you.
> Anything against Niaspan - the prescription slow-release form of > niacin that is well tolerated? Dosage info is provided. see > www.niaspan.com
The same concerns as those about niacin worsening insulin resistance for someone with MetS.
And it costs a lot more.
Is the inositol bound niacin which causes no flushing as effective as the ordinary form?
Yes, ime.
Humbly,
Andrew
Thanks. I'm due for a blood check soon. After it I will switch from Niaspan to the flush free and see if it makes a difference. I am taking about 1 gram of Niaspan at bedtime. How much and when should I take the other?
On Fri, 07 Nov 2003 16:31:44 -0500, "Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote:
>Brad Sheppard wrote: > >> Anything against Niaspan - the prescription slow-release form of >> niacin that is well tolerated? Dosage info is provided. see >> www.niaspan.com > >The same concerns as those about niacin worsening insulin resistance for someone with MetS.
And it costs a lot more.
Is the inositol bound niacin which causes no flushing as effective as the ordinary form?
Yes, ime.
Humbly,
Andrew
Thanks. I'm due for a blood check soon. After it I will switch from Niaspan to the flush free and see if it makes a difference.
If you are taking it at bedtime, it is surprising that the flushing is bothering you.
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I am taking about 1 gram of Niaspan at bedtime. How much and when should I take the other?
