Niacin and BGLs

After reading about Fiasp, I decided to try taking a little niacin daily. Only source I had in the house was a “women’s multivitamin” that contains 75 mg of niacinamide, so I’ve been taking 1 daily for about a week. My Humalog seems to be working considerably better suddenly, with postmeal BGL peaks much lower. Funny thing is, I seem to be having fever lows as well! Anyone have experience with finding the best dose of niacin for use in T1d BGL maintenance? Thanks!

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Fewer lows that is

Interesting. What is fiasp? I was taking that for lower cholesterol I think but one of my docs said it can cause liver damage and it was giving me headaches etc. so I stopped.

I thought Fiasp was the fast acting Novolog with niacin added to make it even more quickly absorbed

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Niacin does raise your blood sugar. Studies have shown that doses of niacin sufficient to affect cholesterol are actually enough to cause you to move from non-diabetic to diabetic. Sadly, the statinators behind those studies claimed that being diabetic was far worse than having abnormal levels of cholesterol. I really wish I could sneak up on them and totally sl*p them upside the head for harming so many people.

So far, at the lower doses I’m taking, the niacin seems to be lowering my blood sugar rather than raising it (right after meals). Also seems to be leveling out my swings in BGL throughout the day. I assume by “statinators” you’re referring to those seeking to profit from statin sales. I’m looking to find out how to accomplish the same result as Fiasp without having to pay the considerably higher non-formulary costs that what I’d guess you’d call the novolog-gators (or perhaps insulators?) are charging.

My daughter just pointed out to me that the serving size for the multivitamin that I’m taking is 3 tablets daily. Since I’m only taking 1 tab daily, I’m only getting 25 mg of niacinamide each night instead of the 75 mg that I thought I was getting.

Yes, Fiasp is the name of the newest novo nordisk ultra fast acting rapid insulin. My DD takes it.

Which is why I wonder whether we might be able to get the same result by either taking the niacin orally or perhaps placing a tiny drop on skin (for MDI users) before injecting…could save a bit of $ at the pharmacy.

Use of over the counter Niacin (Vitamin B3) is basically to avoid malnutrition. The extreme form is called pellegra and is really bad. But almost all people in the US get perfectly adequate amounts of B3 from their diet (16-18 mg recommended by NIH). And if you take a vitamin that probably provides you with everything you need. My Costco vitamin has 20 mg of B3.

In the case of Fiasp, they added niacinamide (vitamin B3) to help to increase the speed of the initial insulin absorption. I’ve not seen any well founded claims that niacin (the form take orally) improves and speeds insulin absorption. If you are taking niacin orally in the hope that you will increase your insulin absorption, you are probably wasting your money.

In fact you may be making your diabetes worse. According to Medline,

Medications for diabetes (Antidiabetes drugs)
Long-term use of niacin might increase blood sugar. By increasing blood sugar, niacin might decrease the effectiveness of diabetes medications. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), metformin (Glucophage), nateglinide (Starlix), repaglinide (Prandin), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

Note that these effects are most pronounced in the historical use of niacin in treatment of cholesterol which is typically at dosages of 500mg or higher.

Thanks for your input, Brian. Each of us, here, at tuDiabetes represents a case study in blood glucose control if we pay close attention to our behavior and apparent consequences. What I’m seeking in this forum is not the best of the known data (I already access that at PubMed and elsewhere.) I want to hear about the range of individuals’ experiences with day-to-day management to see whether anyone else here has noted significant BGL changes with either the addition to or removal from their therapeutic regime of either niacin or a multivitamin containing niacin. I was taking no oral niacin supplement of any kind before reading what others here wrote about their experiences with Fiasp. Surprisingly, upon adding a multivitamin containing only 25 mg niacin to my diet, I noted what appeared to be a significant flattening of the range of BGLs on my Dexcom and lower postprandial peaks. That encouraged me to share this with you all to draw upon others’ experiences and see whether we might not all improve our control even if we do not have access to what I understand may be another expensive industry drug tweak. My own recent BGL improvements may be due to some other as yet unrecognized factor as well, hence my desire to hear about others’ experiences to help form my personal hypothesis.

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Yes, each of us is different. My personal experience with prescribed Niaspan at 500 and 1000 mg doses were that it raised my blood sugars. And hence, when I sought out why that was the case, I found that studies and medical advice confirmed that effect. I hope your improved blood sugars contiue.

Thanks for the encouragement. If you hear of anyone else having seeming effects like mine, please invite them to post here.

I looked it up after reading your question. I didn’t notice that it had any afffect on my Bg. I can’t remember how much I was taking. That’s good it’s helping you.

This is interesting-there’s some solid research out now around niacin preventing miscarriage in women (not necessarily diabetics). Unfortunately sorry I don’t have any articles to reference-it was on the news and my GP also encouraged me to take it (planning TTC).
I wonder if it is linked to blood glucose control in some way.
I have noticed this bizarre stability in my numbers lately however where I’m just not spiking as badly as I would normally…I haven’t been paying close enough attention to whether that’s the B3 supp or not though (I’ve been taking it very sporadically). I’ve also recently done a lot of setting tweaking…too much variability to know for sure.

So, my doctor and I have recently experimented with very high doses (therapeutic) of Niacin to see what it would do for my Cholesterol levels. I don’t have bad Cholesterol, but they were in the “higher than desirable for a diabetic” category. Long story short, 1500 mg a day (two 500mg in the morning for a horrible flush and one 500mg in the evening) did serious number on my lipids panel. Along with high dose fish oil, my LDL was super-low, HDL was very high (highest it’s ever been), and triglycerides were rock-bottom (probably partially due to low-carb eating as well).

However, my fasting BGs were creeping back up into the “diabetic range.” I.e., nine months ago my FBG was averaging around 85 mg/dL. Two months ago it was up to 100mg/dL, with occasionally seeing 115s and 125s (with keeping Metformin the same dosage and eating about 50g of carbs per day). So, we cut out the Niacin to see what would happen.

Haven’t gotten a lipid panel yet, but my FBG have continued to rise, and I’ve since doubled my Metformin ER doses morning and evening. We’ll see what lipids look like without the Niacin, but so far it appears that while Niacin can raise BG, it wasn’t affecting my FBG significantly (while amount of Metformin was).

I’ll have to check back after my next panel and see what the A1c and lipids are like.