Question on Fatty Liver

[Guest guest]

---Marianne, Dr. Sandra Cabot has some wonderful recommendations

for " fatty liver " :

 

http://www.liverdoctor.com/

 

Excellent site!!

JoAnn

 

In Gettingwell , Marianne <mschulz10@s...> wrote:

> Alobar,

> I've done searches on Niacin and diabetes, and I am definetly

confused

> (doesn't take much) if Niacin would be helpful or not. But then I

also read

> that one should not take Niacin if you have liver problems, so I

don't know

> if a fatty liver is a severe problem. Well let's hope someone

responds to

> our post and gives us some insight to your question.

>

> MArianne

>

> ----

>

> gettingwell

> Tuesday, January 21, 2003 1:16:07 PM

> gettingwell

> Re: Question

>

>

> -

> " Marianne " <mschulz10@s...>

>

> Tuesday, January 21, 2003 12:46 PM

> Question

>

>

> > Hello Everyone,

> >

> >

> >

> > I have type 2 diabetes, and a fatty liver!! Would it be alright to

> start

> > taking Niacin. Anyone know??

> >

> >

> >

> > Thanks for your help

> >

> >

> >

> > Marianne

>

> I was getting ready to pose nearly the same question to this

> list. I have been pondering the niacin question now for over a

year.

> I have heard conflicting reports about use of niacin for diabetics

> (see below). I know nothing of fatty livers, so can't guess about

> that one. Niacin does indeed raise blood glucose levels.

> However, taking niacin does supposedly does not negatively impact

> long-term blood glucose levels as measured by glycosylated

hemoglobin

> A1c (HbA1c).

>

> Back before I fired my doctor I asked her about this very

> topic & showed her the info I have placed below. I asked her if it

> would be ok for me to take niacin but just adjust the blood glucose

> aim points I was looking to achieve (which she had informed me

should

> be under 127 for fasting glucose measurement, and under 200 for post

> prandial). And if so, how much should I adjust the aim points. My

> doc told me not to take niacin & I should in *no* circumstances

> adjust the aim points higher.

>

> I have recently been reading the really good stuff about

> niacin posted to this list & am now re-thinking the niacin question.

> But I have no answers. I have no money to purchase HbA1c blood

> testing. So I am nervous about taking niacin. Back last year, I

> did some experimentation. Niacin does indeed spike my blood sugar &

> keeps the blood glucose readings high for several days after a

single

> 500 mg dose. The raised blood sugar appears to be cumulative (the

> readings keep climbing if I take niacin daily). I have only taken

> niacin for 7 days in a row, but so no plateau in my fasting glucose

> readings, so I stopped. Also, the readings take nearly a week to

> return to " normal " after I stop taking niacin if I have taken 500 mg

> a day for a week.

>

> Alobar

>

>

> Niacin is relatively contraindicated in diabetic patients because it

> can worsen blood sugar control. In selected patients, Niacin may be

> used, but blood sugar control must be monitored closely.

> http://www.aboutdiabetes-

endocrinology.com/1_dia/dm09_cholesterol.htm

>

>

> The ADMIT Study: A Randomized Trial

> JAMA. 2000;284:1263-1270

> There are concerns regarding the use of niacin in patients with

> diabetes because of the potential negative effect on glycemic

> control. In this report, Elam and colleagues describe results of a

> study to assess the effect of niacin treatment on plasma

lipoproteins

> and glycemic control in patients enrolled in the Arterial Disease

> Multiple Intervention Trial (ADMIT). The ADMIT is a prospective,

> placebo-controlled trial of patients with peripheral artery disease

> to evaluate the effect of niacin, antioxidant vitamins, and low-dose

> warfarin on risk factors for atherosclerosis. Of the 468

participants

> enrolled in the ADMIT, 125 had diabetes.

>

> During a 12-week run in period, all patients received niacin at

doses

> that were increased at 4-week intervals. Subjects were then

> randomized to receive either 3000 mg/d or a maximally tolerated

> amount of niacin or placebo for 48 weeks.

>

> Compared with placebo, treatment with niacin resulted in a

> significant increase in high-density lipoprotein cholesterol and

> significant decreases in triglycerides and low-density lipoprotein

> cholesterol in subjects with and without diabetes. Niacin treatment

> resulted in a small but statistically significant increase in

glucose

> in patients with and without diabetes, respectively (0.4 and 0.3

> mmol/L). Treatment with niacin was not associated with an increase

in

> glycosylated hemoglobin A1c (HbA1c) in patients with diabetes.

>

> The investigators concluded that for diabetic patients who cannot

> tolerate or do not adequately respond to statin or fibrate drugs,

> niacin might provide a therapeutic alternative.

> www.diabetesincontrol.com/issue30/item9.htm

>

>

>