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Januvia Insulin

What Is Januvia®?

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. 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 >>

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 >>

The Effectiveness Of Combination Treatment With Insulin And Sitagliptin In T2 Patients

The Effectiveness Of Combination Treatment With Insulin And Sitagliptin In T2 Patients

Patients on therapy may see increased reduction in HbA1c, lower BP, lower lipid values…. Dipeptidyl peptidase-4 (DPP-4) inhibitors are used for the treatment of type 2 diabetes. Sitagliptin was the first medication approved for people with type 2 diabetes who are taking insulin. There are not a lot of studies that have investigated the use of DPP-4 and insulin therapy in patients with long-term diabetes diagnosis. Currently, there aren’t any studies that have evaluated the efficiency of DPP-4 inhibitors in activating insulin feedback in patients with minimal insulin secretion who are on insulin therapy. Researchers evaluated the effectiveness and safety of insulin-sitagliptin combination treatment to establish the benefit of this regimen in patients with type 2 diabetes. The study design was a multicenter retrospective study from November 2011 to March 2013. The study was conducted in 36 diabetes clinic in Kanagawa Prefecture, Japan. Patients who were eligible were on insulin 6 months prior and on sitagliptin if their HbA1c was 7.0% or higher with insulin therapy. The primary endpoint was the variation in HbA1c levels. The results from this study were reported as mean + standard deviation. Other endpoints in this study were weight, blood pressure values, total cholesterol, and triglycerides. The study included 1,169 patients. The results showed that most patients (n=809) received sitagliptin 50mg. In 1,004 patients, HbA1c was reduced by 0.74% and body weight was increased by 0.1kg after 6 months of combination treatment of insulin and sitagliptin. In this study, hypoglycemic events occurred in 7.4% of the patient population, however none of the events were severe. Also, a multiple regression analysis on 114 patients showed that C-peptide had no effect on the effecti Continue reading >>

Sitagliptin; Januvia

Sitagliptin; Januvia

are allergic to dapagliflozin or any of the ingredients in FARXIGA. Symptoms of a serious allergic reaction may include skin rash, raised red patches on your skin (hives), swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking FARXIGA and contact your healthcare provider or go to the nearest hospital emergency room right away have severe kidney problems or are on dialysis. Your healthcare provider should do blood tests to check how well your kidneys are working before and during your treatment with FARXIGA Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL Kidney problems. Sudden kidney injury occurred in people taking FARXIGA. Talk to your doctor right away if you reduce the amount you eat or drink, or if you lose liquids; for example, from vomiting, diarrhea, or excessive heat exposure Serious urinary tract infections (UTI), some that lead to hospitalization, occu 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 >>

Januvia Side Effects Center

Januvia Side Effects Center

Januvia (sitagliptin) is an oral diabetes medicine for people with type 2 diabetes (non-insulin-dependent) diabetes. Januvia is sometimes used in combination with other diabetes medications, but is not for treating type 1 diabetes. Many people using Januvia do not have serious side effects. Side effects that may occur with Januvia include: headache, joint or muscle pain, nausea, stomach pain, diarrhea, or constipation. Although Januvia by itself usually does not cause low blood sugar (hypoglycemia), low blood sugar may occur if Januvia is prescribed with other anti-diabetic medications. Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. Tell your doctor if you have serious side effects of Januvia including pancreatitis (severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite, fast heart rate), urinating less than usual or not at all, swelling, weight gain, shortness of breath, or severe skin reaction (fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads [especially in the face or upper body] and causes blistering and peeling). The recommended dose of Januvia is 100 mg once daily. Januvia may interact with digoxin, probenecid, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin or other salicylates, sulfa drugs, monoamine oxidase inhibitors (MAOIs), or beta-blockers. Tell your doctor all prescription and over-the-counter medications you use. During pregnancy Januvia should be used only when prescribed. Pregnancy may cause or worsen diabetes. Your doctor may change your diabetes treatment during pregnancy. It is unknown if this drug passes into breast milk. Cons Continue reading >>

Combining Incretin-based Therapies With Insulin

Combining Incretin-based Therapies With Insulin

What is the rationale for adding incretin-based therapies to insulin? The combination of the incretin-based therapies, i.e., the dipeptidyl peptidase (DPP)-4 inhibitors and glucagon-like peptide (GLP)-1 receptor agonists (GLP-1RAs), with basal insulin has, in theory, logical appeal. While basal insulin primarily improves fasting plasma glucose (FPG) control, the glucose-dependent effect of incretins will additionally benefit postprandial plasma glucose (PPG) control. This should enable improved control of A1C with the expectation of relatively stable blood glucose concentrations, and the combination of incretins with basal insulin might reduce insulin dose requirement and, consequently, weight gain. This also supports the concept that combining the incretin-based therapies with basal insulin should enable tight glycemic control with a low risk of hypoglycemia. Furthermore, a reciprocal benefit of this combination is that the basal insulin will theoretically supplement endogenous insulin production and “rest” the β-cell, enabling greater recovery of the endogenous insulin response when required. The basis of this theory is formed from research showing benefits with incretin therapies for β-cell function (1) and β-cell mass in experimental systems (2–4). In addition to their antihyperglycemic properties, GLP-1RAs also reduce gastrointestinal motility, which, together with increased satiety, produces a weight-sparing effect (2). This quality could mitigate the weight gain associated with insulin therapy and might be further enhanced through any reductions in insulin dose. 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 >>

Compare Januvia Vs. Human Insulin

Compare Januvia Vs. Human Insulin

Oral blood sugar-lowering medicine. Januvia (sitagliptin) is not linked to worsening heart failure like other medicines in its class. It is less likely to cause weight gain and low blood sugar compared to other diabetes medicines. Some types of this medication are available without a prescription. Available as a shot to be injected into the fatty part of the skin, and as a powder to be inhaled through your nose. Available in different combinations so that you can do one shot or multiple shots a day. 143 reviews so far Have you used Januvia (sitagliptin)? Leave a review 57 reviews so far Have you used Humulin (Human Insulin)? Leave a review The Humulin (Human Insulin) FDA package insert doesn’t have numbers about how common side effects are. History of pancreatitis High blood triglyceride levels Gallstones (stones in gallbladder) History of alchoholism Kidney problems Continue reading >>

Sitagliptin Added To Stable Insulin Therapy With Or Without Metformin In Chinese Patients With Type 2 Diabetes

Sitagliptin Added To Stable Insulin Therapy With Or Without Metformin In Chinese Patients With Type 2 Diabetes

Sitagliptin added to stable insulin therapy with or without metformin in Chinese patients with type 2 diabetes 1Merck & Co., Inc., Kenilworth, New Jersey, USA 2Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 3Shengjing Hospital of China Medical University, Shenyang 4The Second Affiliated Hospital of Soochow University, Suzhou 5Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing 6Shanghai First People's Hospital affiliated to Shanghai Jiaotong University, Shanghai 8Present address: Novartis Pharmaceuticals (China), Beijing, China R Ravi Shankar, Email: [email protected] . Email address: [email protected] , Author information Article notes Copyright and License information Disclaimer Received 2016 Jul 25; Revised 2016 Sep 19; Accepted 2016 Oct 11. Copyright 2016 Merck Sharp & Dohme Corp. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the Creative Commons AttributionNonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. This article has been cited by other articles in PMC. We evaluated the tolerability and efficacy of the addition of sitagliptin in Chinese patients with type 2 diabetes mellitus receiving stable insulin therapy alone or in combination with metformin. A total of 467 patients with inadequate glycemic control on insulin (glycated hemoglobin [HbA1c] 7.5% and 11%) were randomized 1:1 to receive sitagliptin 100 mg once daily or a matching placebo for 24 weeks. Randomization was stratified based on metformin use (on or not on metformin) and type of insu 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 - Fda Prescribing Information, Side Effects And Uses

Januvia - Fda Prescribing Information, Side Effects And Uses

Januvia is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. [See Clinical Studies (14) .] Januvia should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis, as it would not be effective in these settings. 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 for the development of pancreatitis while using Januvia. [See Warnings and Precautions (5.1) .] The recommended dose of Januvia is 100mg once daily. Januvia can be taken with or without food. Recommendations for Use in Renal Impairment For patients with an estimated glomerular filtration rate [eGFR] greater than or equal to 45 mL/min/1.73 m2 to less than 90 mL/min/1.73 m2, no dosage adjustment for Januvia is required. For patients with moderate renal impairment (eGFR greater than or equal to 30 mL/min/1.73 m2 to less than 45 mL/min/1.73 m2), the dose of Januvia is 50 mg once daily. For patients with severe renal impairment (eGFR less than 30 mL/min/1.73 m2) or with end-stage renal disease (ESRD) requiring hemodialysis or peritoneal dialysis, the dose of Januvia is 25 mg once daily. Januvia may be administered without regard to the timing of dialysis. Because there is a need for dosage adjustment based upon renal function, assessment of renal function is recommended prior to initiation of Januvia and periodically thereafter. There have been postmarketing reports of worsening renal function in patients with renal impairment, some of whom were prescribed inappropriate doses of sitagliptin. 100mg tablets are beige, round, film-coated tablets with "277" on one side. 50mg tablets are light beige, round, film-coated t Continue reading >>

Sitagliptin Plus Basal Insulin Comparable To Basal-bolus Regimen In Type 2 Diabetes

Sitagliptin Plus Basal Insulin Comparable To Basal-bolus Regimen In Type 2 Diabetes

Sitagliptin Plus Basal Insulin Comparable to Basal-Bolus Regimen in Type 2 Diabetes Sitagliptin Plus Basal Insulin Comparable to Basal-Bolus Regimen in Type 2 Diabetes Patients who used a combination therapy of sitagliptin plus basal insulin for type 2 diabetes management had similar hospital length of stay, daily blood glucose concentration levels, and rates of hypoglycemia compared with patients who used a more labor-intensive basal-bolus insulin regimen, according to results from a prospective, randomized clinical trial published in The Lancet Diabetes & Endocrinology. Francisco J Pasquel, MD, from Emory University in Atlanta, and colleagues randomly assigned 277 patients between August 2013 and July 2015 to receive treatment with once-daily sitagliptin plus basal glargine (n=138) or a once-daily basalt 2013 and July 2015 to receiv and rapid-acting insulin lispro or aspart (n=139) taken before meals. Patients, aged 18 to 80 years, were from 5 different hospitals; had type 2 diabetes; were taking diet or oral antidiabetic drugs; and had a total daily insulin dose of 0.6 units per kg and a random blood glucose concentration of 7.8 to 22.2 mmol/L. Guidelines from professional organizations for the management of non-critically ill patients with type 2 diabetes admitted to hospital recommend the use of basal-bolus insulin regimens, which are labor-intensive and associated with a risk of hypoglycemia, Dr Pasquel and colleagues wrote. The results of our clinical trial show that treatment with the DPP-4 inhibitor sitagliptin and basal insulin once daily is similarly efficacious and safe compared to multidose regimens with basal insulin once daily and rapid-acting insulin before meals in patients in hospital with uncontrolled glucose concentrations. The researchers found bot Continue reading >>

Adding Januvia To Insulin-treated Type 2 Diabetes Patients Could Have Cardiovascular Benefits

Adding Januvia To Insulin-treated Type 2 Diabetes Patients Could Have Cardiovascular Benefits

Adding Januvia to insulin-treated type 2 diabetes patients could have cardiovascular benefits Adding Januvia to insulin-treated type 2 diabetes patients could have cardiovascular benefits Adding vildagliptin and protein preload could benefit metformin-treated men with type 2 diabetes, study reports 25 January 2016 The addition of Januvia (sitagliptin) to insulin therapy could have benefits for adults with type 2 diabetes and no history of cardiovascular disease , a Japanese study finds. Januvia , the brand name for sitagliptin, is a DPP-IV inhibitor which is used to lower the blood glucose levels of people with type 2 diabetes. It can be taken alongside other medication, such as insulin. Researchers at Juntendo University Graduate School of Medicine, Tokyo, analysed data from 282 Japanese adults with type 2 diabetes. None of the participants had cardiovascular disease (CVD) and all were treated with insulin. They wanted to evaluate the effect of oral hypoglycemic agents on the progression of atherosclerosis , a condition which occurs when arteries become clogged up by fatty substances known as plaques. Atherosclerosis is a major risk factor for CVD. The participants were randomly allocated either to the sitagliptin group or a control group. In the drug group, patients took up to 100mg of sitagliptin once-daily. Patients in the control group either received increased insulin doses, or had a sulphonylurea , glinide, or alpha-glucosidase inhibitor added to their treatment. Echography was used to measure changes in mean and maximum intima-media thickness (IMT) of the common carotid artery (CCA) - which supplies blood to the head and neck - before the study and at 52 and 104 weeks. The IMT of the CCA is a marker of subclinical atherosclerosis and can increase with age. Sita Continue reading >>

Insulin And Januvia

Insulin And Januvia

Hello all, I have been on Tresiba for about a month now and am doing really well with fasting numbers 95 to 110. Although all is going well with fasting numbers my after meal numbers could use some improvement. I am not sure if I should convince my doctor to be put on a bolus insulin or try to go back on januvia? My post meal numbers are usually never higher than 160's. My diet is pretty good for breakfast and lunch but dinner and pre-bed snacks are usually not as good as I want. I would like to try a fast acting insulin for dinners only. Anyone have experience with Januvia? is it safe? Will I have to adjust my basal insulin so I don't go low? I have been on Januvia and my after meal numbers were around 130's. Your thoughts would be greatly appreciated. I was at a time on Janumet and Insulin (Janument contains metformin and januvia). It worked well for me. D.D. Family Getting much harder to control I have no experience with Januvia, its great your numbers are as well as they are. Look at what you are eating and then decide from that. I take Januvia and Metformin. Januvia helps my fasting and in between meals but really doesn't help my after meal bgs if I eat normal carb meals. 115 pounds, Breast Cancer dx'd 6/16, 6 months of chemo and 6 weeks of radiation 2000 metformin ER, 100 mg Januvia,Glimperide, Prolia, Gabapentin, Meloxicam, Probiotic with a Prebiotic, , Lisinopril, B-12, B-6, Tumeric, Magnesium, Calcium, Vit D, and Occuvite mostly vegan diet, low fat and around 125 carbs a day, walk 5-6 miles every other day and 1 hour of yoga and light weights. Continue reading >>

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