Tags: Diabetes | diabetes | drugs | comparison | januvia | metformin

Are Diabetes Drugs Equally Effective?

By    |   Thursday, 22 May 2014 09:44 AM

Question: I was taking Januvia to control my diabetes, but my endocrinologist switched me to metformin a few months ago because of new concerns about Januvia. Unfortunately, the metformin makes me feel sick and dizzy. When I told my doctor, he said I should just go back on the Javunia, because the concerns were unfounded. Is it really safe, or should I be worried? 

Dr. Hibberd's answer:
The use of Januvia recently has come into question regarding its risk/benefit concerns. I am relatively indifferent to its use, and use it rarely. It is not as safe as using insulin, and hence the concerns. It is also quite expensive. It is to be regarded as an adjunct in treatment for those who cannot tolerate insulin treatment, but require more intensive glucose control than the oral agents they are using.
Metformin is not always well tolerated, but is by far the best oral agent we have for Type 2 diabetes, because it sensitizes cells to insulin without raising insulin levels. High insulin levels will accelerate atherosclerosis, and we do not want sustained insulin elevations because of this risk.
The use of Januvia has not demonstrated clear advantages over existing oral and insulin treatment regimens enough to support its extra cost in most circumstances. 

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Metformin is not always well tolerated, but is by far the best oral agent we have for Type 2 diabetes.
diabetes, drugs, comparison, januvia, metformin
Thursday, 22 May 2014 09:44 AM
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