Jason,
Actually the acceptance data DID show an increase in cancers. The way the data is reported obscures this, but Dr. Goldstein’s letter to Archives of Internal Medicine (linked from my Januvia page) suggests an additional 60,000 cancers a year would be caused by Januvia just extending the findings of the acceptance trials.
Researchers at a major cancer center are aware of this issue and I’m told they are researching it.
Januvia is extremely expensive. Almost $5 a pill or $180 a month.
Actos is also expensive.
Metformin alone costs $4-$8 a month as it is generic. But the drug company is promoting a combo Janumet pill with Januvia and Metformin combined which is extremely expensive.
Dear Lucille.
Your comment is too truncated for me to reply to could you elaborate a bit more. are you totally off the levemir or are you a 4 units split morning night? Yes insulin resistance has the benefit of not allowing lows or having mild ones.
Wow another great treatment.
Although if/when I get to the point where I need it to control my bg, I will switch to insulin and be grateful for it, for the present the simple meds I’m taking (metformin) are helping my body fight my primary problem, which is insulin resistance. I obviously still have lots of insulin running around in my body unable to get into my cells without help, and metformin provides that help. For me it seems silly to take more insulin when I still clearly have a lot of my own. (I have read the posts that taking insulin right away helps preserve beta cells, haven’t decided what to think about that for now, especially as I have had diabetes for nearly a decade. For me, I was prescribed metformin, which works for me, to “protect my pancreas,” that is, keep from burning it out with meds that force it to produce yet more insulin.)
“Please, people. Don’t take Januvia.”
I generally don’t go to this type of extreme with drugs because there is always the pros vs cons to do and mostly the pros of a drug do outweigh the cons. However, Januvia is one of the only drugs I agree with you on, don’t take it. The other interesting things that have come up recently are all the problems the other drug manufacturers are having coming up with DPP-4 inhibitors. Most have had awful problems with severe side effects. I would say that DPP-4 inhibitors are great in theory if you only look at lowering blood sugar, but in reality you have to look at the whole system and when you do that it does seem to be quite a bad thing to do.
Sorry, Anthony. I’d be happy to clarify: My only diabetic drug is Januvia 100 mg 1X day; I’m totally off the Levemir. Initially, I was on Levemir 8 units at bedtime. After pancreatic surgery (underwent Frey procedure in continuity with a Roux-en-Y cystojejunostomy of multiple pancreatic pseudo cysts, as well as a side-to-side choledocho cystojejunostomy) in July '08, I was on 4 units Levimer at bedtime. Prior to starting Januvia in midMarch '09 because of increasing fasting bs, I stopped taking Levimer for about two months (I tried exercise & diet alone with no improvement). So I’ve been on Januvia for about two months, and I’m an “Other” type diabetic.
Jason, I can only speak for myself - but my internist threw some pills at me and considered that to fulfill her responsibility for medical care. I had to ask for a glucose monitor and for additional blood work and to change my medication. Prescribing insulin or anything beyond metformin isn’t even in her vocabulary. I will meet with my new doctor for the first time next week.
Truth be told, I’m afraid of insulin (not of injections) because of the potential for weight gain and especially for night time lows.
Good thing you are switching to a new doctor. It took me years to find a health care provider that actually puts all of her effort into balancing her side of the diabetes equation with me.
The weight gain issue is only an issue if you are eating too much and not exercising. If you only have enough insulin to cover what you eat, there is no excess in your body pushing calories into fat cells. Night time lows can be tough, for sure. I admit after 14 years I still have issues there sometimes. Nothing drastic but it plain sucks waking up in the 50s and having to spend an hour in the middle of the night dealing with it.
Duncan,
The reason that the other DPP-4 inhibitors aren’t getting approved is that UNLIKE Januvia, they were tested for more than 18 months.
The very short time Januvia was tested and the very small number of people involved in the trials are a major concern.
Another drug which also lowers DPP-4 via messing with an interleuken is used for arthritis. Its test period was longer and it definitely turned up a “more than expected” incidence of melanoma. The absolute number was small, but multiplied by the hundreds of thousands of people being put on Januvia, it turns into hundreds of people who die unnecessarily.
If a drug is being prescribed for rheuratoid arthritis that cripples people and has few effective treatments, the risk might be bearable. But Januvia does NOTHING other drugs don’t do and it does it with a higher level of risk.
Today’s blog post on my Diabetes Update blog covers the latest evidence that GLP-1 does NOT rejuvenate beta cells, which is relevant to the hype being used to sell Januvia.
The journal Diabetes is the premier peer reviewed journal publishing research devoted to diabetes. It’s run by the American Diabetes Association. It’s also fairly conservative in what it publishes.
Jenny,
Thanks for the link to your most recent blog post of today, simplifying the latest evidence that GLP-1 doesn’t rejuvenate beta cells. I’ve added that info to my growing pile of papers about Januvia. It all makes my head spin. My learning curve is steep. I wish that all things diabetes were as clear to me as they are to you. Further, today I came across info about my surgeon, who is also a professor, stating that he is available to give talks on topics, such as “GLP-1: A Rival to Insulin as the Master Hormone.” So I intend to get his opinion on my diabetes treatment, considering the most recent study. Again, thanks, Lucy
Dear Lucille.
Why risk your life on something unknown. Insulin has ben tried extensively and except for the get fat problem appears to be fairly safe. Surely even 10 injections into the tummy grease are a mild inconveiniance compared to the possible horror of this drug.
Dear Yvonne.
If you are worried about weight gain then you may be somewhat insulin resistant and night time lows are much less of an issue than for proper diabetics. God is not that mean you win some and loose some.
Jenny,
You wrote: “Januvia is extremely expensive. Almost $5 a pill or $180 a month.” Are those figures in regards to with or without insurance? Again, I’ve got my Januvia for free to date. My copayment under my insurance for any Januvia will be $25 for 30 pills. CVS pharmacy’s quote for out of pocket or w/o insurance Januvia is $237.10 for one month, $473.99 for two, and $710.99 for three. (Senior citizen discount, deduct 10%.)
On the other hand, my insurance covered 30 cents of my last prescription filled for 200 BD Ultra-Fine Pen Needles. So I paid $55.43 out of pocket for the needles needed for my Levemir flexpens. I injected 1X day. Seemingly, needles can be expensive depending on how many times a diabetic injects insulin a day. (I never reused my needles while on Levemir, but I probably won’t hesitate to reuse any in the future at least once. Because I’ve always been a frugal person and now I’m enlightened TuDiabetes member concerning reusing lancets and needles, and more.)
Just wanted to clarify that I was referring to the link to your most recent blog on your Diabetes Update blog of May 1, 2009, New Study Proves Conclusively Byetta Does Not Regrow Beta Cells, regarding “A study published in this month’s Diabetes Care is titled in a way that makes it sound like Byetta “improves beta cell function.””
You blogged in conclusion: “It’s also worth noting that the mechanism by which Byetta was supposed to be rejuvenating beta cells is the same mechanism used by the other incretin drug, Januvia, for which the identical claim is being made. This new study suggests that Januvia is not regenerating beta cells either.” (My emphasis added).
Thanks! Yikes, is not what I had to say after reading this. I am not part of a study…
I have been concerned about all the meds I’m on. Actos, Januvia and Levimir. And still having high BG’s (my fastings are usually 130-175). The only thing any of this seems to have helped is my 2 hour spikes. It has brought them from 300+ down to around 200 (mostly just a little under 200) that is for a 15 to 20 carb meal.
As for side effects. I don’t know anymore. I am to the point that I do not know if how I feel is sugar related or medicine induced. I have developed some pretty intense headaches. As I was reading these posts on the 30th I sent my little one upstairs to wake my big one and stood up from the computer and woke up on the floor. I was only out for a matter of seconds, my daughter had just made it to the steps about 6 feet away. BG was the lowest I’ve seen in months but that was only 115! I have been dizzy since. Now this could be attributed to the BP medication that I have been on for 3 months with out incident but it could also be ???
I will call the doc on Monday but I don’t hold any hope for any real answers from her. I can’t call the endo for advice because I am a new patient with my first appointment at the end of the month. So I am in limbo for any real treatment. Feels like I’ve been here since December when I went to the ER! It is soooo frustrating.
Thanks Gerri, nice to hear others get upset about this. Sometimes I think I’m too hard on doctors I have fired 3 within the last 6 months. Only one has been there for me and been truthful in the fact that the system sucks and this is how we play the game the fastest to get me to an endo.
My med costs are $25 per medication for a months supply. $50 for the Levimir which is a 3 month supply. These prices are with my insurance. They originally started me out on older generic medications so I could get the Walmart $4 prices. None of which worked…
Hi Samantha,
For your info, below is the link to the “Clinical trial: Januvia plus insulin” that I wrote about above on April 30th. First, since that time, the link has either been updated, stating in relevant part that “This [Merck] study has been completed”–or else, I didn’t click on “Read full story >” the first time I came across the link. Notably, the bottom of the “Sitagliptin Added-on to Insulin Study” page says in relevant part: “ClinicalTrials.gov processed this record on May 01, 2009.” (Emphasis added by me.)
http://www.healthcentral.com/diabetes/news-267228-98.html
Perhaps one of the other more knowledgeable TuDiabetes members, such as Jenny, can tell us how to find out the outcome of the Januvia plus insulin clinical study.
I’m wondering why Merck hasn’t updated the patient information sheet that comes with Januvia tablets to reflect their study. My most recent leaflet, which says “Revised October 2008” states in relevant part: “JANUVIA has not been studied with insulin, a medicine known to cause low blood sugar.”
Importantly, I’m sorry you passed out. When I first started treatment for diabetes using Levemir 8 units at bedtime, I would get feelings of shakiness around only 115, which I corrected by eating about 7 grams of carbs–usually 1T peanut butter and an apple slice–as recommended by my diabetes educator. Once, 115 was low for me too. I’m not on BP meds. Hope the above info helps. Please let us know the outcome of your telephone call to your doctor. Best regards, Lucy
Samantha, makes me livid!