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Diabetics and cholesterol

This article was originally published in The Tan Sheet

Executive Summary

Niacin megadoses could be an alternative to statin drugs or fibrates in lowering LDL cholesterol and raising HDL cholesterol, Marshall Elam, MD/PhD, University of Tennessee, et al., conclude in a review of the Arterial Disease Multiple Intervention Trial (ADMIT) conducted from August 1993 through December 1995. The review appears in the Sept. 13 JAMA. While previous studies suggest niacin therapy may lead to glucose intolerance in diabetics, the ADMIT researchers assert it "can be used safely in patients with stable, controlled type 2 diabetes." However, Elam et al. caution statins and fibrates should remain the first-line intervention. Of 468 participants in the prospective, randomized, placebo-controlled trial, 125 were diabetic and 64 received 3,000 mg per day or the "maximum tolerated dosage" of niacin. The established upper limit for niacin is 35 mg/d; CRN opposes marketing niacin supplements that exceed 500 mg per dose
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