1. Which of the following statements regarding use of nicotinic acid for lipid lowering in diabetics is false?
1. Majority of diabetics are intolerant to nicotinic acid because it worsens glycemic control.
2. The major reason for intolerance of nicotinic acid among diabetics are its non glycemic side effects.
3. Diabetics are more comfortable with crystalline nicotinic acid as it has minimal effects on glycemic control.
4. Diabetics are highly intolerant to crystalline nicotinic acid as the incidence of flushing is higher.

Answer: Nicotinic acid induces insulin resistance and hence causes glucose intolerance. But this is not the reason for diabetics being intolerant to nicotinic acid. The most important reason for intolerance to nicotinic acid irrespective of whether one is diabetic or not is its non glycemic side effects which include flushing, itching and hepatotoxicity. Crystalline nicotinic acid has lesser incidence of glycemic effects but has more itching, flushing and hepatotoxicity.

Flushing may be reduced if one takes Aspirin about 30 minutes before the Niacin dose.