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Can You Take Januvia And Insulin Together

Important Safety Information

Important Safety Information

WHAT IS JANUVIA®? JANUVIA (jah-NEW-vee-ah) is a once-daily prescription pill that, along with diet and exercise, helps lower blood sugar levels in adults with type 2 diabetes. JANUVIA should not be used in patients with type 1 diabetes or with diabetic ketoacidosis (increased ketones in the blood or urine). If you have had pancreatitis (inflammation of the pancreas), it is not known if you have a higher chance of getting it while taking JANUVIA. Serious side effects can happen in people who take JANUVIA, including pancreatitis, which may be severe and lead to death. Before you start taking JANUVIA, tell your doctor if you've ever had pancreatitis. Stop taking JANUVIA and call your doctor right away if you have pain in your stomach area (abdomen) that is severe and will not go away. The pain may be felt going from your abdomen through to your back. The pain may happen with or without vomiting. These may be symptoms of pancreatitis. Before you start taking JANUVIA, tell your doctor if you have ever had heart failure (your heart does not pump blood well enough) or have problems with your kidneys. Contact your doctor right away if you have increasing shortness of breath or trouble breathing (especially when you lie down); swelling or fluid retention (especially in the feet, ankles, or legs); an unusually fast increase in weight; or unusual tiredness. These may be symptoms of heart failure. Do not take JANUVIA if you are allergic to any of its ingredients, including sitagliptin. Symptoms of serious allergic reactions to JANUVIA, including rash, hives, and swelling of the face, lips, tongue, and throat that may cause difficulty breathing or swallowing, can occur. If you have any symptoms of a serious allergic reaction, stop taking JANUVIA and call your doctor right away. Kid Continue reading >>

Sitagliptin Approved As Add-on To Insulin

Sitagliptin Approved As Add-on To Insulin

Sitagliptin approved as add-on to insulin Sitagliptin approved as add-on to insulin Sitagliptin (known as Januvia) has been approved by the European Commission as an add-on to insulin (with or without metformin)for people with Type 2 diabetes who cannot control their condition effectively with a combination of diet, physical activity and insulin. Sitagliptin is a once-daily DPP-4 inhibitor thatworks by blocking the action ofDPP-4, an enzyme which destroys the hormone incretin. Incretins help the body produce more insulin only when it is needed and reduce the amount of glucose being produced by the liver when it is not needed. Further option for people with Type 2 diabetes We welcome any advances that help improve quality of life for people with diabetes," said Pav Kalsi, Care Advisor at Diabetes UK. "When it is not possible for people with Type 2 diabetes to achieve good blood glucose control through lifestyle and current medication, Diabetes UK recognises that a wide choice of treatment options, including Januvia (sitagliptin) in combination with insulin, can help. People with diabetes should have as wide a choice as possible of effective treatments for their condition. Good blood glucose control is essential for people with diabetes to improve wellbeing and protect against long-term damage to the eyes, kidneys, nerves, heart and major arteries. Continue reading >>

Should You Take A Medication With Your Insulin?

Should You Take A Medication With Your Insulin?

Should You Take A Medication With Your Insulin? People with Type 1 and Type 2 diabetes who are already on insulin but are looking for better readings can often benefit from taking another medication with their insulin. Consider the benefits and drawbacks of these meds that can assist insulin before you try them. Symlin (pramlinitide) replaces amylin, a hormone normally secreted by the same cells that make insulin. In Type 1 diabetes, levels of both insulin and amylin are very low or absent, while in Type 2 diabetes insulin and amylin levels are initially higher than normal and then fall off as beta cell activity is gradually lost over time. Like the GLP-1 agonists discussed below, Symlin slows digestion, minimizes glucagon secretion to reduce the amount of glucose the liver releases into the blood, and often reduces excess appetite. Significant reduction in post-meal glucose spikes May help those who are overweight lose a few pounds Often reduces the amount of insulin required per day OK with heart or liver problems, no known kidney problem Injected 2 to 3 times a day before meals and cannot be mixed in with insulin May cause nausea initially, less so when doses are gradually increased Hypoglycemia can occur if insulin doses are not reduced enough Can slow treatment of hypoglycemia with food because digestion is slowed Byetta, Victoza, and Bydureon ( GLP-1 agonists ) are called incretins and have similar benefits to Symlin but for a different reason. GLP-1 agonists got their name because they mimic the effects of GLP-1, short for glucagon-like peptide-1, a special chemical messenger secreted by cells in the intestine when foods come in contact with the intestinal lining. Two incretins, GLP-1 and GIP, are responsible for as much as 70% of the insulin release that occurs Continue reading >>

Can Januvia And Glipizide Be Taken Together Safely?

Can Januvia And Glipizide Be Taken Together Safely?

Community Answers No, The two drugs are virtually identical. If both of the drugs are taken together may potentiate the risk of hypoglycemia. Yes Januvia can be taken with any other medication for Type 2 diabetes. There are studies in the prescribing information of januvia used in combination with glipizide, metformin, insulin. There are no contraindications to take the two products together, however, it is recommended to closely monitor patients hypoglycemia when januvia is used together with any sulfolyurea like glipizide. I take glipizide, metformin at their max dose and januvia (a newbie med). My diabetes is still out of control. my weight does not change. I eat no refined sugars. In the last 18 months my digestion has changed so dramatically that I can eat nothing but bland foods (mostly cereals). Know more here READ THESE NEXT: Can a new diabetes drug also help my mother lose weight? Essential Info About Type 2 Diabetes Drugs When Blood Sugar High Continue reading >>

Can You Take Metformin And Januvia Together

Can You Take Metformin And Januvia Together

What type of drug is Metformin Metformin is a Generic name for a drug with antihyperglycemic properties that is used for treating non – insulin – dependent diabetes mellitus. This drug can improve glucose levels in blood by decreasing the production of glucose in liver, decreasing intestinal absorption of glucose and increasing insulin-mediated glucose uptake. Therapy with metformin may also decrease the risk of having a stroke, heart attack, or other diabetes-related complications. Metformin can induce weight loss and that’s why it is the drug of choice for obese patients with diabetes type two. When it is used alone, this drug doesn’t cause hypoglycemia as side effect; but, it may potentiate the hypoglycemic effects of sulfonylureas drugs and insulin if they are used together. Metformin is available in the form of tablet in following dosage forms: 500, 750, 850 and 1000 mg. It is usually taken during meals. Common Brand names on the market containing metformin as an active ingredient are: Glucophage, Glumetza, Glucophage XR, Fortamet, Metformin Sandoz, Diabex, Diaformin, Siofor, Metfogamma and Riomet. What is Januvia Januvia is a Brand name for a drug containing sitagliptin as an active ingredient. It is an oral diabetes drug that is used to control sugar levels in blood. Januvia works by regulating insulin levels that body produces after eating. This drug is used for the treatment of patints with type 2 diabetes. Januvia can be used in combination with other diabetes medicines, but is not used for treating type 1- diabetes. Patients with diabetic ketoacidosis should not use Januvia. Januvia is available in tablet and film-coated tablet form in following strenghts: 25, 50 and 100 mg. Common Brand names on the market containing sitagliptin as an active ingredie Continue reading >>

Use Januvia Concomitantly With Insulin: Strong A1c Reductions1

Use Januvia Concomitantly With Insulin: Strong A1c Reductions1

As an adjunct to diet and exercise for appropriate patients with type 2 diabetes FAS = full analysis set; LS = least squares. This is an electronic version of a figure published in Diabetes, Obesity and Metabolism Volume 12, Issue 2, pages 167-177, February 2010, published by Wiley. As an adjunct to diet and exercise for appropriate patients with type 2 diabetes PPG = postprandial glucose; FPG = fasting plasma glucose; FAS = full-analysis-set; LS = least squares. JANUVIA is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. JANUVIA should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. JANUVIA has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk of developing pancreatitis while taking JANUVIA. Selected Important Risk Information About JANUVIA® (sitagliptin) tablets JANUVIA is contraindicated in patients with a history of a serious hypersensitivity reaction to sitagliptin, such as anaphylaxis or angioedema. There have been postmarketing reports of acute pancreatitis, including fatal and nonfatal hemorrhagic or necrotizing pancreatitis, in patients taking JANUVIA. After initiating JANUVIA, observe patients carefully for signs and symptoms of pancreatitis. If pancreatitis is suspected, promptly discontinue JANUVIA and initiate appropriate management. It is unknown whether patients with a history of pancreatitis are at increased risk of developing pancreatitis while taking JANUVIA. An association between dipeptidyl peptidase-4 (DPP-4) inhibitor treatment and heart failure has been observed in cardiovascular outcomes trials for two other members of the DPP-4 inhibitor class. Continue reading >>

Adding Of Sitagliptin On Insulin Therapy Effectively And Safely Reduces A Hemoglobin A1c Level And Glucose Fluctuation In Japanese Patients With Type 2 Diabetes

Adding Of Sitagliptin On Insulin Therapy Effectively And Safely Reduces A Hemoglobin A1c Level And Glucose Fluctuation In Japanese Patients With Type 2 Diabetes

Adding of Sitagliptin on Insulin Therapy Effectively and Safely Reduces a Hemoglobin A1c Level and Glucose Fluctuation in Japanese Patients with Type 2 Diabetes 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan 2Municipal Yame General Hospital, Yame 834-0034, Japan 3Kouhoukai Takagi Hospital, Okawa 831-0016, Japan 5Shimada Hospital, Ogori 838-0141, Japan 6Tenjinkai Koga Hospital 21, Kurume 839-0801, Japan 7Saint Mary Hospital, Kurume 830-8543, Japan 8Tenjinkai Shin-Koga Hospital, Kurume 830-8577, Japan Received 10 March 2014; Accepted 5 June 2014; Published 3 August 2014 Copyright 2014 Yuji Tajiri et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Aims. Efficacy and safety of DPP-4 inhibitor, sitagliptin, add-on therapy to insulin were investigated in Japanese patients with type 2 diabetes. Subjects and Methods. Two hundred and sixteen patients (126 men, 65 12 years old, BMI 24.9 4.5, means S.D.) who had been treated by insulin alone or insulin combined with other oral hypoglycemic agents (OHAs) were recruited, and sitagliptin was added for 3 months. Results. HbA1c was significantly decreased after 3 months of add-on therapy as a whole (8.56 1.50% to 7.88 1.25%, ). Body weight did not change and insulin dosage was significantly ( ) decreased for 3 months. Furthermore, day-to-day glucose variability was significantly reduced (18.3 9.1 to 16.1 8.1%, ). In stepwise multiple regression analysis on HbA1c as an outcome variable, the higher baseline HbA1c value and a preserved CPR were selected as signific Continue reading >>

Metformin, Glipizide, Januvia, And Actos Related Questions

Metformin, Glipizide, Januvia, And Actos Related Questions

Metformin, Glipizide, Januvia, and Actos Related Questions Metformin, Glipizide, Januvia, and Actos Related Questions A friend's father (age 70+) is taking all of those drugs, and I wonder if that's a dangerous mix. I read about them today, and it seems Actos is the worst, followed by Glipizide. I also read in an older thread here that it's dangerous to take Actos and Januvia together. Why is that? Is that an unwelcome combination only for causing weight gain? He thinks one of these drugs is raising his cholesterol levels, but I didn't find it mentioned among the side-effects of any of them. I think only Actos could be a potential suspect, although some studies show it may lower cholesterol. What do you think? He is mildly anemic with no apparent reason. I've seen it mentioned many times here that Metformin depletes vitamin B12, but his B12 is within the lab ranges. I don't really trust many of those ranges, so I think he could still be B12 deficient with a result of 432 (211 - 946). Need to ask if he is supplementing with B12. Continue reading >>

Combined Therapy With Insulin Plus Oral Agents: Is There Any Advantage?

Combined Therapy With Insulin Plus Oral Agents: Is There Any Advantage?

Physicians in many countries use combinations of antihyperglycemic agents to achieve the best glycemic control possible under the conditions faced by individual patients with type 2 diabetes. This widespread use of combined therapies, including oral agents combined with insulin, suggests that the diabetes community accepts the value of this tactic. A routine need for combined therapies was explicitly acknowledged by the investigators in the U.K. Prospective Diabetes Study. Review of the results of 9 years of monotherapy with various agents in the U.K. Prospective Diabetes Study found that fasting plasma glucose (FPG) was kept below 7.8 mmol/l (140 mg/dl) in only 18% of participants using metformin, 24% using a sulfonylurea, and 42% using insulin (1). Corresponding values for keeping A1C below 7% were 13% with metformin, 24% with a sulfonylurea, and 28% with insulin. Regardless of which agent was used as initial therapy, a progressive worsening of glycemic control ensued, largely because of a gradual decline of endogenous insulin production. A substudy embedded in the U.K. Prospective Diabetes Study compared early addition of basal insulin to a sulfonylurea with insulin alone and showed that over 6 years of treatment the combined regimen achieved lower median A1C (6.6 vs. 7.1%) and also less major hypoglycemia (1.6 vs. 3.2% annually) (2). The U.K. Prospective Diabetes Study investigators concluded that “the majority of patients need multiple therapies to attain these glycemic targets in the longer term” (1). However, combined therapy with oral agents and insulin has not been accepted as desirable by all experts. This article describes an argument in favor of combined therapy in a recent debate examining the advantages and limitations of this approach. Because reports Continue reading >>

Triple Combination Of Insulin Glargine, Sitagliptin And Metformin In Type 2 Diabetes: The Easie Post-hoc Analysis And Extension Trial

Triple Combination Of Insulin Glargine, Sitagliptin And Metformin In Type 2 Diabetes: The Easie Post-hoc Analysis And Extension Trial

Abstract We examined the effects of adding glargine to metformin–sitagliptin (MS + G) or sitagliptin to metformin–glargine (MG + S) therapy in type 2 diabetic persons uncontrolled after 24-week MS or MG dual therapy. Subjects with A1c ≥ 7% on MS or MG treatment were respectively given glargine (0.2 U/kg starting dose) or sitagliptin (100 mg daily) for 12 weeks. The primary endpoint was number of subjects attaining A1c goal defined as < 7%. After receiving 24-week MS or MG dual therapy in the original EASIE Study, 42% (104/248) on MS and 68% (152/224) on MG attained A1c < 7% (p < 0.0001). The reduction in A1c was negatively associated with baseline fasting blood glucose (FBG) only in the MG group. Reduction in A1c was not related to baseline postprandial blood glucose (PPBG) in either the MG or MS group. Amongst 194 eligible patients, 57.7% (n = 111) entered the 12-week extension trial [MS + G:74/131, 57.3%; MG + S:37/63, 58.7%) with 55 (51.9%) subjects attaining goal [MS + G:59.2%; MG + S:37.1%] at week 12. The final insulin dosage was similar in both groups [MS + G: 0.46 U/kg; MG + S: 0.45 U/kg] with a higher rate of hypoglycemia in the MG + S (6.5 events/patient-year) than the MS + G group (3.2 events/patient-year), although neither group had severe hypoglycemia. In metformin-treated type 2 diabetes patients, high fasting BG predicted greater A1c reductions with the addition of glargine, but not with sitagliptin. In subjects uncontrolled with 6-month dual therapy of MS or MG, 50% attained A1c < 7% with triple therapy of MS + G or MG + S in 12 weeks. The increased rate of hypoglycemia with MG + S (but not with MS + G) underlines the need to take measures to avoid the hypoglycemia. Conflict of Interest: J.C.N. Chan, P. Aschner, D.R. Owens, M. Vincent, M-P. Dain, V Continue reading >>

Efficacy And Safety Of Sitagliptin When Added To Insulin Therapy In Patients With Type 2 Diabetes.

Efficacy And Safety Of Sitagliptin When Added To Insulin Therapy In Patients With Type 2 Diabetes.

Abstract OBJECTIVE: To evaluate the efficacy and tolerability of sitagliptin when added to insulin therapy alone or in combination with metformin in patients with type 2 diabetes. METHODS: After a 2 week placebo run-in period, eligible patients inadequately controlled on long-acting, intermediate-acting or premixed insulin (HbA1c > or = 7.5% and < or = 11%), were randomised 1:1 to the addition of once-daily sitagliptin 100 mg or matching placebo over a 24-week study period. The study capped the proportion of randomised patients on insulin plus metformin at 75%. Further, the study capped the proportion of randomised patients on premixed insulin at 25%. The metformin dose and the insulin dose were to remain stable throughout the study. The primary endpoint was HbA1c change from baseline at week 24. RESULTS: Mean baseline characteristics were similar between the sitagliptin (n = 322) and placebo (n = 319) groups, including HbA1c (8.7 vs. 8.6%), diabetes duration (13 vs. 12 years), body mass index (31.4 vs. 31.4 kg/m(2)), and total daily insulin dose (51 vs. 52 IU), respectively. At 24 weeks, the addition of sitagliptin significantly (p < 0.001) reduced HbA1c by 0.6% compared with placebo (0.0%). A greater proportion of patients achieved an HbA1c level < 7% while randomised to sitagliptin as compared with placebo (13 vs. 5% respectively; p < 0.001). Similar HbA1c reductions were observed in the patient strata defined by insulin type (long-acting and intermediate-acting insulins or premixed insulins) and by baseline metformin treatment. The addition of sitagliptin significantly (p < 0.001) reduced fasting plasma glucose by 15.0 mg/dl (0.8 mmol/l) and 2-h postmeal glucose by 36.1 mg/dl (2.0 mmol/l) relative to placebo. A higher incidence of adverse experiences was reported wi Continue reading >>

Sitagliptin Is Effective And Safe As Add-on To Insulin In Patients With Absolute Insulin Deficiency: A Case Series

Sitagliptin Is Effective And Safe As Add-on To Insulin In Patients With Absolute Insulin Deficiency: A Case Series

Sitagliptin is effective and safe as add-on to insulin in patients with absolute insulin deficiency: a case series 2Division of Diabetes and Endocrinology, Department of Internal Medicine, Gyoda General Hospital, Saitama, Japan Received 2010 Oct 8; Accepted 2011 Mar 28. Copyright 2011 Kutoh; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. It is generally believed that incretin-based therapies are effective in patients possessing certain levels of preserved -cell function. So far, there are no reports that show the effectiveness of dipeptidyl peptidase-4 inhibitors in patients who absolutely lack the capacity for endogenous insulin secretion. This report describes the efficacy of sitagliptin in three Japanese patients (a 91-year-old Japanese woman with type 1 diabetes, a 54-year-old Japanese man with type 2 diabetes and a 30-year-old Japanese man with features of both type 1 and type 2 diabetes) who had no detectable post-meal C-peptide levels. Although they were receiving intensive insulin therapy together with some oral hypoglycemic agents, their glycemic control remained poor. Sitagliptin was added to the ongoing therapeutic regimen to provide better glycemic control. Although these patients had mild hypoglycemia, effective reductions of hemoglobin A1c levels were observed without any adverse events in the liver and kidney during the following 24 weeks. Two of the patients were able to reduce their insulin doses, and one of the patients could discontinue one of the oral hypoglycemic agents. There was no w Continue reading >>

Januvia® May Help Lower Your Blood Sugar (a1c)

Januvia® May Help Lower Your Blood Sugar (a1c)

JANUVIA (jah-NEW-vee-ah) is a once-daily prescription pill that, along with diet and exercise, helps lower blood sugar levels in adults with type 2 diabetes. JANUVIA should not be used in patients with type 1 diabetes or with diabetic ketoacidosis (increased ketones in the blood or urine). If you have had pancreatitis (inflammation of the pancreas), it is not known if you have a higher chance of getting it while taking JANUVIA. IMPORTANT SAFETY INFORMATION Serious side effects can happen in people who take JANUVIA, including pancreatitis, which may be severe and lead to death. Before you start taking JANUVIA, tell your doctor if you've ever had pancreatitis. Stop taking JANUVIA and call your doctor right away if you have pain in your stomach area (abdomen) that is severe and will not go away. The pain may be felt going from your abdomen through to your back. The pain may happen with or without vomiting. These may be symptoms of pancreatitis. Before you start taking JANUVIA, tell your doctor if you have ever had heart failure (your heart does not pump blood well enough) or have problems with your kidneys. Contact your doctor right away if you have increasing shortness of breath or trouble breathing (especially when you lie down); swelling or fluid retention (especially in the feet, ankles, or legs); an unusually fast increase in weight; or unusual tiredness. These may be symptoms of heart failure. Do not take JANUVIA if you are allergic to any of its ingredients, including sitagliptin. Symptoms of serious allergic reactions to JANUVIA, including rash, hives, and swelling of the face, lips, tongue, and throat that may cause difficulty breathing or swallowing, can occur. If you have any symptoms of a serious allergic reaction, stop taking JANUVIA and call your doctor right Continue reading >>

Merck's Januvia Effective In Combination Studies

Merck's Januvia Effective In Combination Studies

Merck's Januvia effective in combination studies * Januvia plus Actos superior to Actos alone * 60 pct of patients reach blood sugar goal vs 28 pct NEW YORK, June 6 (Reuters) - Merck & Co Incs ( MRK.N ) fast growing diabetes drug Januvia proved effective in helping patients lower blood sugar in combination with Takedas Actos, and when used along with insulin therapy, according to data from a pair of clinical trials. In a 497-patient, 24-week study, treatment with Januvia plus Actos as an initial therapy resulted in a 2.4 percent reduction in A1C level compared with a 1.5 percent reduction for patients taking the Takeda Pharmaceutical Co Ltd ( 4502.T ) drug alone, Merck said. The difference was considered to be statistically significant. A1C is a key measure of a persons average blood glucose level over a two- to three-month period. The American Diabetes Association (ADA) guidelines call for A1C levels of 7 percent or less. Type 2 diabetes patients began the trial with A1C levels of 8 percent to 12 percent. Sixty percent of those who received the combination therapy achieved an A1C of less than 7 percent, compared with 28 percent of patients who only took Actos, known chemically as pioglitazone, according to data presented on Saturday at the annual ADA scientific meeting in New Orleans. Januvia, known chemically as sitagliptin, belongs to a new class of diabetes medicines called DPP-4 inhibitors. Actos belongs to the older, widely used thiazolidinedione, or TZD, class of drugs for the growing type 2 diabetes epidemic. Over time most type 2 diabetes patients require multiple drugs to achieve glycemic control, said John Amatruda, Mercks head of diabetes and obesity and one of the studys authors. Amatruda said these studies should show doctors that getting patients to goal Continue reading >>

What You Should Know About Januvia And Metformin

What You Should Know About Januvia And Metformin

Januvia and Metformin are both oral diabetes drugs that are used to control high blood sugar in people with diabetes. Diabetes is a chronic condition where a person cannot make enough insulin or use it properly. Insulin is a natural hormone that is produced by the beta cells in the pancreas. This naturally occurring hormone works by transporting glucose into the body tissues where it is stored and used for energy. Glucose is a form of sugar which is one of the main sources of energy for the body. Without insulin, glucose cannot get into the cells. This leads to a build up of glucose in the bloodstream, which, if not treated, could lead to life threatening conditions. People with type 2 diabetes and a valid prescription can take Januvia and Metformin as a combination medicine together with exercise and diet to control blood sugar levels. However, you should not take these medications to treat type 1 diabetes. Type 1 diabetes is a condition where the pancreas produces little or no insulin as a result of the immune system mistakenly attacking the beta cells. What is Januvia? Januvia is the brand name of sitagliptin and works by regulating the amount of insulin that is produced after taking a meal. You should not take this medicine if you are allergic to sitagliptin or in a state of diabetic ketoacidosis. This medication is not supposed to be taken by anyone who is below the age of 18. You can take it with or without food. What is Metformin? Metformin is an oral diabetes drug which is used to treat type 2 diabetes. Metformin is the brand name of glucophage. This medication can be taken in combination with other medications to control blood sugar levels. The medication works in the body by reducing the amount of glucose that is produced in the liver and decreasing glucose ab Continue reading >>

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