Harvard Heart Letter

Ask the doctor: Is niacin okay for people with diabetes?

Ask the doctor

Is niacin okay for people with diabetes?

Q. I have been taking niacin for several years, and it has helped keep my good and bad cholesterol in their healthy ranges. Now I have been diagnosed with diabetes, and my doctor forbids me from taking niacin any more. What's the reasoning behind this?

A. Niacin is one of the oldest drugs for treating cholesterol problems. Not only does it lower LDL (bad) cholesterol and triglycerides, but it is also the best medication for increasing HDL (good) cholesterol.

In the mid-1980s, a few small studies showed that high doses of niacin increased blood sugar levels among people with diabetes or prediabetes. This work prompted the American Diabetes Association to recommend that the drug be used cautiously, at doses under 2 grams a day, and with frequent blood sugar monitoring. Many doctors took this to mean that niacin shouldn't be used by people with diabetes.

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