Januvia question

Hi -

Sorry if this is a question that’s already been answered! I’ve researched it quite a bit and I’m seeing a lot of different views. I was just put on 50 mg of Januvia (in addition to my 1000 mg/day of Metformin, low carb and exercise). My question is does Januvia cause beta cell exhaustion?

I’ve seen no, I’ve seen yes and I’ve seen that it actually stimulates and improves beta cell function. Anyone have any insight?

Thanks!

Ah ha!!! So there is another Januvia user in the tudiabetes community. In answer to your question “does Januvia cause beta cell exhaustion?”: I asked the same question when my endocrinologist recommended that I switch from Levimer to Januvia. (Note: I hesitated starting Januvia. I didn’t take any medication for over a month after stopping Levimer but couldn’t control my diabetes with exercise and diet alone. As you probably know, Januvia is a relatively new drug. I believe drugs can be just as–or more–dangerous than the diseases they address; to me, anything that can be done to avoid a prescription drug is preferable.)

My doctor pointed out that in an animal study, Januvia actually improved beta cell function. However, considering info received from this website after I’d already started Januvia, apparently, my doctor is parroting Januvia manufacturer propaganda.

Nevertheless, I’ve not had any side effects on Januvia; my fasting and after meal blood sugars are lower.

So I too have gotten yes and no in answer to the question of whether Januvia “stimulates and improves beta cells function” and I too would appreciate more input about Januvia. I’m seriously considering info about Januvia that Jenny, a member of this community, kindly provided me in the form of links. I’d like to be a better informed patient at my next endo appointment in mid-May. In the meantime, instead of getting a 90-day prescription filled today, I’ve decided to get a prescription filled for a free 30-day trial supply of Januvia (manufacturer voucher)–in case there’s a safer option open to me regarding diabetes treatment.

Best regards, Lucy

You are not an animal, so the good news for juvania may or not apply to humans. The issue of preserving your own pencreas in some working order is critical as it can turn the diabetes from a manageable disease to a horrible nightmare once your own pancreas dies completely.

Is there any good reason to take chances? There is some evidence that supplementing your own pancreas with external insulin and keeping the BG in the normal range does preserve it possibly for a long time in some working order. What other benefit does juvania give to warrant the risk?

So the manufacturer touts that it doesn’t cause weight gain, can help to preserve/improve beta cell function, is not known to cause any damage to the heart like other Type 2 meds can, etc, etc. They say overall it’s a very “clean” medication with the only side effects being upper respiratory infection, runny nose and headache (the upper respiratory infection seems to be a weird side effect if you ask me, I haven’t had it).

I know these are from the manufacturer so I do keep that in mind. My doctor is open to starting me on insulin but right now the Januvia, metformin and low carb diet is working. I’m not opposed to insulin, just wary of the roller coaster of bg’s since i do still produce some of my own insulin.

I agree with your comments, though Anthony.

No you would not be on a high low roller coaster with insulin since you would need very low amounts. the roller coaster becomes a reality once your pancreas dies.

Hello Anthony Holko and EsMom,
Seemingly, Januvia suppresses my appetite and I’m slowly loosing weight on it. My very strong desire for snacks between meals has gone away along with feelings of shakiness (low blood sugar for me around 115) since starting Januvia. Indeed, today I looked at the clock at 1:30PM and realized that I hadn’t snacked since breakfast or eaten lunch at noon. The patient prescription info sheet I received with my pills today states in part: Sitagliptin [Januvia] “works by increasing levels of natural substances called incretins. Incretins help to control blood sugar by increasing insulin release, especially after a meal. They also decrease the amount of sugar our liver makes.” Further: “Sitagliptin is used alone or with other medications to control high blood sugar along with a proper diet and exercise program.” (My emphasis added as I seem to get better readings after exercising and, of course, limiting my carb intake.)

However, I also agree with Anthony. That meaning, the manufacturer’s claim that Januvia doesn’t cause weight gain and my belief that it seems to suppress my appetite should not trump concerns about preservation of remaining pancreatic function.

So, who do we believe regarding diabetes and Januvia? Our doctors can’t cure us; they can only try to treat our symptoms with medication(s) or diet and exercise or a combination of both.

Best regards, Lucy

well if the stuff causes you to loose weight and keeps your BG in the normal range then it may be ok. That is way better than the sulphonyl ureas that caused weight gain and poor BG control.

It is not 100% sure than insulin will help keep the pancreas alive in all type 2’s. I would be a real help if mild diabetics were given different treatments to see scientifically what does the best job of keeping the pancreas alive. In my case diet, metformin and sulphonyl ureas did not do the job. I suspect insulin would have but since you cannot play your life over again there is no way to be sure.

That’s interesting because everyone I know with Type 1.5 (or 2) that are on insulin but still producing some of their own insulin is on a major rollercoaster. From day to day you never know how much insulin your own pancreas will decide to spit out. So, you could take x units today and be perfectly fine, tomorrow, that same amount of insulin sends you into the 30’s or vice versa.

I’ve learned that everyone’s diabetes is unique to them - that’s part of the “fun”! : )

Hi Lucy -

Januvia’s done the same thing to me. While I don’t necessarily need to lose weight, I am losing a just a bit on this medication. Mostly because I don’t have much of an appetite and my overall interest in food is pretty much gone. Not such a bad thing I guess because I’m still eating, just not overdoing it.

I’m not sure what the best route is. I try not to stress over it too much because I know what the BEST overall treatment is and that’s insulin. So right not it’s just making that decision of whether to go on insulin if I don’t absolutely have to you or wait it out…

Insulin the best except for weight gain. The more so a problem if you are insulin resistance. Otherwise gives the best possible control.