Anyone tried both Januvia and Janumet? Did one work better for you than the other?
I have been on Janumet for past 4yrs and so far so good. But I combined w Diamicron 60mg. My janumet is 1000/50, morning & dinner time. I was on Januvia before, then went back to Glucophage, but my A1C was still high, then doctor changed my meds to Janumet & Glucophage for lunch time only. I am T2, my A1C 6,5
can I ask the rationale and reasoning behind using Janumet?
It seems to squeeze your pancreas for more insulin… where your pancreas are already strained… arent you over working it?
with a long list of side effects…
why not just get on insulin…?
Actually I think you are criticizing the Diamicron (gliclazide) which is a class of drug called sulphonylurea which has the action you describe. Yes, it has been associated with burning out your pancreas and isn’t a durable medication. Janumet is a combination of Januvia (a DPP-4) and metformin. Personally I would never take a sulphonylurea drug. There really isn’t a difference between taking Januvia and metformin vs taking Janumet. You are more limited in timing and dosing because you take them together but you also can get two drugs for one co-pay.
Janumet too
JANUMET targets 3 key factors to lower blood sugar:
Helps your pancreas make more insulin
Helps your body more effectively use the insulin that it makes
Helps decrease excess sugar that your liver makes
Yes, Januvia helps your pancreas release more insulin response to meals. It essentially amplifies the incretin hormones. But it doesn’t directly signal your pancreas to release insulin all the time and as far as I have seen it isn’t associated with straining or burning out your pancreas.
[quote=“Brian_BSC, post:6, topic:50316”]
incretin hormones
[/quote] Isnt incretin an hormone that stimulates insulin secretion ( through pancreas) in response to meals ? The ultimate squeeze is on pancreas?
[quote=“RaDe, post:7, topic:50316, full:true”]
The difference is that the GLP-1 and DPP-4 drugs amplify a natural signal which is often defective in type 2. This restores a natural type of response. The sulphonylurea signal the pancreas directly in an unnatural way to release insulin and that insulin is released in a highly variable manner, even when you don’t need it when fasting between meals. Thus the sulphonylurea can cause hypoglycemia a nasty side effect. And furthermore the GLP-1 drugs are actually associated with beta cell preservation rather than beta cell burnout as has been found with the sulphonylurea drugs.
In general the result of sulphonylurea drugs is insulin production, not unlike insulin. My opinion is that someone prescribed a sulphonylurea would do better to just take a basal or bolus insulin. Insulin won’t burn out your pancreas like a sulphonylurea and you can achieve much better fine tuning and control.
How do you distinguish between the lack of signals vs insulin production to prescribe the right drug?
A simple way of identifying the issues is asking whether you have constantly elevated blood sugars when you are fasting and whether you have high blood sugars after meals. If your fasting blood sugars are elevated you are a good candidate for a basal insulin. If your blood sugars are elevated afer meals you might do well with a GLP-1/
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