Effectiveness of niacin supplementation for patients with type 2 diabetes
What this study found
Niacin supplementation improved lipid outcomes in adults with type 2 diabetes mellitus, lowering total cholesterol, triglycerides, and LDL cholesterol while increasing HDL cholesterol. Glycemic effects were not consistent: plasma glucose and HbA1c did not change significantly overall, although some analyses suggested possible worsening of glycemic control at higher niacin doses. The overall pattern supports lipid benefit but calls for caution because of potential dose-related effects on glucose control.
- Study & population
- Systematic review and meta-analysis of 8 randomized controlled trials in 2110 adults with type 2 diabetes mellitus.
- Intervention
- Oral niacin supplementation was tested in multiple formulations, including immediate-release and extended-release niacin; some regimens used niacin/laropiprant or added niacin to background statin or statin/ezetimibe therapy.
- Key limitation
- The evidence base was small and heterogeneous, with variable niacin formulations, doses, durations, and background therapies.
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Open PDFOriginal abstract
Supplemental Digital Content is available in the text Abstract Background: Lipid profiles and glycemic control play a critical role in subsequent atherosclerotic cardiovascular disease for patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the effectiveness of niacin supplementation on lipid profiles and glycemic control for patients with T2DM. Methods: The PubMed, Embase, and the Cochrane Library databases were searched to identify randomized controlled trials (RCTs) that investigated the effects of niacin supplementation for patients with T2DM throughout December 2019. The weighted mean differences (WMDs) with 95% confidence intervals (CIs) were applied to calculate the pooled effect estimates using a random-effects model. Results: Eight RCTs comprised a total of 2110 patients with T2DM who were selected for final quantitative analysis. The patients’ niacin supplementation was associated with lower levels of total cholesterol (WMD, −0.28; 95% CI, −0.44 to −0.12; P = .001), triglyceride (WMD, −0.37; 95% CI, −0.52 to −0.21; P < .001), and low-density lipoprotein (WMD, −0.42; 95% CI, −0.50 to −0.34; P < .001). Moreover, the level of high-density lipoprotein was significantly increased when niacin supplementation (WMD, 0.33; 95% CI, 0.21 to 0.44; P < .001) was provided. However, niacin supplementation produced no significant effects on plasma glucose (WMD, 0.18; 95% CI, −0.14 to 0.50; P = .275) and hemoglobin A1c (HbA1c) levels (WMD, 0.39; 95% CI, −0.15 to 0.94; P = .158). Conclusions: This study found that niacin supplementation could improve lipid profiles without affecting the glycemic levels for patients with T2DM. Additional large-scale RCTs should be conducted to evaluate the long-term effectiveness of niacin supplementation.