Medication options for type 2 treatment

Hello everyone,

I’m curious what kind of success other people have had with Janumet, either alone or when combined with Glimepiride (Amaryl). My doctor has mentioned changing either one or the other or upper the doses I currently take. My last A1c was 6.9 up from6.5. I can’t seem to lose any significant weight and I’m really bothered by reflux/heartburn, which the doctor feels may be related to the use of either medication.

I’d love to hear some suggestions, insight or experiences from other type 2 diabetics.
Thanks so much.

I took Januvia and metformin together and it gave me such bad stomach problems that I went to emergency twice thinking I was having a heart attack. My stomach problems got so bad that it started to impact my blood pressure. The acid reflux was so bad that I could not even eat healthy food. I was on 100 of Januvia and 1500 daily of metformin. From what I understand is that Janumet is part januvia and part metformin. In top of the stomach problems I had a lot of issues with joint problems, anxiety, panic attacks all caused from Januvia. The endo did not admint it but I never had those problems until I got on Januvia and the withdrawler from Januvia was so bad. I got fed up with my endo and went cold turkey off the Januvia. That is when even more problems came about. I was not able to sleep a week after I stopped taking Januvia. It was weird it was like I was having a drug withdrawl. Also I had a lot of trouble focusing while on Januvia. I was always in a daze. I never had those problems before Januvia.

I dont think Januvia or Janumet has been around long enough like metformin so I dont think doctors know what it will do in the long term. My A1C was between 6.5 and 6.9 when the endo tried to put my on Januvia. That drug scared the hell out of me that I excercise every day for about 1 to 2 hours. My stomach is still bad til this day. It top of that my a1c only went down from like 6.9 to 6.8 for the six months I was on that drug. Today if the doc does not like my A1C he is going to have to give me insulin. I understand insulin is not a magic bullet but at least it wont tear my stomach up. I was on insulin when I was first diagnosed.

If you have more question feel free to send me a message

wil v,

Thanks for the reply and the insight. I’m dealing with many of the reactions you mentioned…stomach problems and serious acid reflux, trouble focusing, panic attacks. I’ve mentioned these to my doctor and her reply is to exercise and lose weight. That’s pretty much it. I’ve been on metformin ever since I was diagnosed over 11 yrs ago.
My big concern is the combination of januvia (in the janumet) and the glimepiride. I’ve been getting what I can only describe as heart flutters since being on both.
I would like to take you up on your offer to ask some questions as soon as I can get some thoughts in order. Thank you so much.

Hi judith,
As far as diet, since I got the A1c of 6.9 the beginning of November I’ve been trying to do a high protein/low carb diet. Not easy, though, because I have to be very careful of the type of protein as I get kidney stones easily.
Exercise has been difficult because I work 6 days a week at 2 different desk jobs, both 8 hour shifts. I try to go for a hike when I can but to be completely honest I don’t exercise as much as I should or could.

I feel like I’ve hit a wall in regards to how I’m able to handle this dis-ease.

Another thing I noticed when summer kicked in I was swimming with my son practically everyday for about an hour and biking for about 7 miles. As I got more fit the Januvia symptoms got worse. It was like the drug did not mesh well with the healthier lifestyle. When I could not get help from my endo I dropped him. I dont know why doctors dont take the side effects seriously. I work as a software engineer and if I cant think straight I am not going to be able to keep my job. I think there are better approaches then dealing with medication. Almost everyday I was running home with stomach problems that would take 2 to 3 hours to clear up. Now I put my foot down on treatments. If metformin stops for me insulin is going to be my next choice. I had some serious problems with very high blood pressure while in januvia that i could not even correct with the highest doses of blood pressure meds.

Hi Janet,

Know a lot of people resist the idea, but insulin may make your life easier. It preserves your beta cells & doesn’t have side effects many experience with meds. Takes a bit to learn doses, but not really that difficult & certainly better than reflux. Some Type 2s just use basal insulin (slow acting background insulin once or twice a day) either alone or with meds. Other Type 2s use small doses of rapid acting insulin before meals to prevent spikes from food. It depends when your highs are–after eating or morning fasting or both.

Thanks Judith…I’m open to any help! I look forward to your post.

Hi Gerri,

My doctor hasn’t mentioned using insulin and to be honest, I’ve always been worried about getting to that point. I don’t really know enough to say yes or no as to whether or not I’d be willing to give it a try. My morning fasting readings are high, 170-200, so if it would help with that…again, I’m open.
Thanks for your response.

I’m on januvia, glimperide, metroformin, crestor and prandin. no ill effects that i’m aware of but guess i’m the lucky one. I exercise a fair bit and my A1C has been between 6.6 and 6.9 for the last 2years

Hi Joe,

Thanks for the reply. It really comes down to exercise, I think, for me. Spoke to my doctor today and she felt I should really focus on the high protein/low carb eating and exercise as much as I can. She didn’t want to change any medications at this time.

Hi Judith,

Wow…thanks so much for all this information and the time you put into it. Let me try to answer some of your questions.
No thyroid problems, per say, but also little to no tofu. I was lacto-ovo vegetarian for quite some time but I found the more soy and tofu I ate, the more swollen my neck would get. Test were run and it appeared I had some small growths on my thyroid. The doctor suggested cutting out the soy products as I didn’t want to go on any more meds. I admit, at the time I was using soy as a main source of protein, and after 6 months and a 2nd ultrasound, no growths were found. I’ve learned, the more soy/tofu I eat…the more swollen my neck gets.

I’m more of an omnivore…this high protein/animal protein eating is difficult, mainly due to ethics and cost. I need to have variety in my diet.

In regards to the type of kidney stones…my GP calls me her “crystal patient” because I get so many different types of stones…kidney, gall stones, salivary gland stones…and she thinks I may have too much calicum in my body. She briefly mentioned Hyperparathyroidism at my last visit but never followed up. I’ve started to do my own research.

No problem with water consumption as I drink 2-3 liters a day.

My doctor told me today she felt the use of insulin was not even in the picture for me at this point. We’ll revisit this in 3 months.

In far as herbs and supplements…I already take the ones you mentioned. I’d love to discuss, in private, the use of various herbs for some of the problems I’ve mentioned with you.

I like what you said about exercise “We just need to figure out how to fit it into the jigsaw puzzle of your daily life. Think about that. It’s NOT impossible and it IS a key part of getting control.” This is so true and I do believe it’s the key for ME gaining control instead of the diabetes.

Again, thank you and thanks to all who have contributed to this topic. I feel empowered instead of frustrated and that’s such a good thing!

FWIW I love exercise just cause it’s a lot cheaper than therapy as well as helping control my sugars. find something you like to do and go with it. good luck and take care

I am not on Januvia, but am on the related medication Byetta and one of the side effects of Byetta is delayed stomach emptying and nausea. I suffer from acid reflux and have lost my cookies a number of times, but consider it just part of the balance. I have gotten some improvement with Byetta, more than I can say about any other medication. I have found that eating smaller meals more frequently throughout the day can help with things. You might want to try that.

On you ‘crystal’ issues, have you had your vitamin D levels tested? Vitamin D turns out to be central to calcium mechanisms in the body. I have tested low and take 8,000 IUs of vitamin D a day. I might have to increase that if I am still low.