Manufactured by Merck Sharp & Dohme Ltd. for diabetes, Januvia (sitagliptin) was approved by the FDA in 2006. Part of the drug family Glitazone, Januvia is a “Gliptin” or oral DPP (dipeptyl peptidase) IV inhibitors. Taken once a day in pill form, Januvia works by increasing insulin production in the pancreas while reducing the amount of glucose made by the liver. Specifically speaking, the drug is an incretin enhancer, meaning it enhances the effects on incretins (hormones produced in the bowel in response to food) that stimulate the release of insulin. Once released into the system, incretins are destroyed by DPP-IV. Januvia prolongs their presence by slowing down their destruction by DPP-IV.
Treating Diabetes – Januvia Side Effects
In clinical trials patients taking Januvia the most common side effects were diarrhea, sore throat, and colds. In some rare cases the drug can lead to mild cases of pancreatitis and increased risk of pancreatic cancer. In a study by the UCLA Larry L. Hillblom Islet Research Center, the risk of pancreatitis was reduced when Januvia is used with the drug metformin (trade name Glucophage). Metformin controls glucose production by the liver. The reason for the side effects of Januvia may be caused by the production of high numbers of cells that line the pancreatic ducts. Additionally, much like Byetta, Januvia increases the effectiveness of the hormone GLP-1, causing hypoglycemia and possibly leading to pancreatitis. The researchers at UCLA were able to establish that the use of metformin and Januvia work together to increase insulin sensitivity while keeping the pancreas healthy. Individuals with type 1 diabetes, diabetic ketoacidosis, or kidney problems should not take Januvia.
Pre Diabetes – Januvia Uses
In a study by Case Western Reserve University and published in Experimental Biology and Medicine, found that sitagliptin reduced glucose levels in pre diabetic obese lab rats while increasing the pancreatic production of insulin, further reducing glucose levels. The researchers found that, in comparison with the diabetes drug gyburide, sitagliptin is equally effective in lowering glucose levels after a meal but only sitagliptin was able to lower glucogen levels to normal and also increase insulin output from the pancreas. Sitagliptin was also found to redistribute body fat from the skin of the abdomen, possibly leading to other health benefits. Interestingly, the researchers at Case Western found that GLP-1, the hormone that may lead to increased risk of pancreatitis, is responsible for the increased effectiveness of sitagliptin. Encouraged by their research, the research team led by Paul Ernsberger and Dr. Richard J. Koletsky suggest that sitagliptin should be further researched in its possible application as a pre diabetes medication.
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