glyburide vs. Januvia?

I have an appointment in a week with my doc and want to do some shaking up with meds (I think). I've been reading a lot about the Januvia and am curious as to what the advantages of it are over the glyburide. Right now I am taking 10m gly/1000m metformin 2X day. I'm thinking about asking the doc to let me try the Januvia instead of the glyburide. I would appreciate any input or info anyone has on these 2 drugs. I have also been doing 5mcg of byetta 2X daily, but it appears to have had so little effect that I stopped it a couple of days ago to see what would happen with my BG numbers. So far there's been no effect on them. I think the low carb diet and exercise has done much more than the byetta.

Karen

I was swiched from Glucophage to Januvia. Results: more side effects no real change. I finally quit using it.

 Actos was a terrible drug for me- it made me gain 40 # over 2 months. It made me swell, gave me sinus problems, and I was depressed all the time. Everything stopped when I stopped taking it.

Januvia has been just the opposite. I have no negative side effects. I have been taking it since April. My sugar levels are very stable all the time. My last A1c was 5.0, and I have no reason to think it will vary much when I have it done next month. It did take about 3  months for the full effects to kick in- but I saw the beginning of good stability after about a week.

Hope you can get off the Actos- especially if you have the swelling!

sandy

Marburg,

I totally understand your frustrations! I took Actos until last spring, but the swelling became unbearable. My ankles felt as though they were going to explode. My doc did put me on byetta, but the lower dosage did absolutely nothing for me and the higher dosage made me extremely sick. I started Januvia a few weeks back, watched my numbers start to creep up so went back to the met/glyburide combo for a week. Decided I didn't like the swings up and down and started the Januvia again a few days ago, but decided not to take any readings for awhile and give it some time to work. Sandy says it takes 1-3 months so I'm going to be patient. I figure if I quite being obsessive about testing then I will stick with it this time. I'm like you ...trying to avoid a higher dosage of byetta and insulin. Changing my diet helped a huge amount. My numbers are much, much better, just not where I want them. So, we can exchange updates in a month or so on how the Januvia is going.

Karen

Hi Karen and Marburg

Actos and Avandia are the same class of drug- the swelling should tell the doctor to get you off of it, because it's the edema that can lead to congestive heart failure. Actos takes 12 weeks to ramp up to full effectiveness, so you won't see very good control until then.

I was also having wild bg swings while I was on the lowest dose of glipizide. I drop down into the high 40's-low 50's with very little exercise- and was always eating carbs to keep myself from dropping too low. I told my doctor that was unacceptable- I can't be passing out on a convention floor during a show- or eating carbs while I do workshops, so we went to Januvia.

I feel so much better. My A1c hasn't really changed much ( 5.2 down to 5.0), but it now reflects good contol all the time rather than a nice average of highs and lows. It really did take awhile for me to see the full benefit, so be patient!

I wish you both well,

sandy 

Well, it's been 1 week. My bs readings are down 20 points. Side effects have been mild (some itching 30 minutes after taking the tablet and more sinus drainage). I hope week 2 shows even more progress.

Marburg

So far my numbers aren't as low as Dr. Bernstein wants them but they are steady and not bouncing all over the place. I seem to have stopped the mid morning spike. So far so good. I, too, am having more of a runny nose. But it's not bad. Sure easier to deal with than the hypos I had with the glyburide.

Hi all,

I have been on Januvia and Glucophage XR for about 4 months now - my history is :

Diabetic 20 years - currently on insulin. Previously on Avandia which caused weight gain and bad leg swelling that has never returned to normal. 2 years ago had 4 stents put in my heart arteries. Don't know that it was caused by using Avandia, but I did have a lot of swelling.

4 months ago my A1c had jumped to 10.2 from my best low of 8.2. The first week on Januvia and Glucophage I saw significant drop in daily BG readings. After 3 months my A1c was at 8.2!

Unfortunately I have gained some weight from the insulin (3.5 years) and Glucophage, and am back at where I was weight-wise 20 years ago. That is very frustrating for me. I was on Glucophage a few years back before Insulin and it also made me gain weight. I also tried Byetta but couldn't get past the extreme nausea and bowel trouble.

At one point about 11 months ago I was down almost 100 pounds; and now it is all back. I don't know how to solve that problem - but my doctor said her concern was that we get the BG and blood pressure in control and not so much worry about the weight right now. I take a lot of meds for blood pressure, cholesterol and triglycerides. As well as Plavix and aspirin with my stents.

Just wanted to share about the Januvia. Give it a chance. It can work!

Barbara in Alaska

Barbara, Welcome to the forum!!!(I have a sister Barb and her screen name is beartwin...she is a twin but not mine)

Anyway I digress. What type of diet are you following? Many of us on this forum have cut out most carbs...no grains, tubers, legumes, fruits, milk (cream and butter are fine). Diabetics just can't tolerate any type of carbohydrate. That's not to say we don't get some. Most vegetables have some...just not the huge amounts that the other stuff does. And are you exercising (although, I admit, I don't do what I should either in this area)? It's amazing how those 2 things can effect the all your numbers...BS, cholesterol, blood pressure, weight. And low carb doesn't mean low fat. You need the good fats to help curb hunger and to help lubricate your skin and hair. I've been losing weight pretty steadily since changing to this way of eating and I really am not feeling deprived. It's amazing the things you can substitute for carbs that taste great!

Thanks for the encouragement about giving it time. I feel like this will work and as I wait for the Januvia to kick in I am still losing weight so that should help, too.

Again, Welcome, this is a great group and ask any question or ask for support and they will come through for you. Keep us posted. :)

Hi Barbara, let me add a welcome to the forum, too.  You could be right about the corn syrup connection and obesity.  Perhaps that and some other factors have contributed to our health problems today and now we're left dealing with them.  I know it's hard changing lifestyle and eating plans because I've done both in the past year.  I would recommend reading Dr. Richard Bernstein's Diabetes Book.  It's full of information about the disease, treatments, food and diet, etc.  This is the one book that has made sense to me about diabetes and given me encouragement to follow a new eating plan.  After being prescribed a glucose monitor a year ago because of high morning blood sugars (measured at my doctor's office), I found myself unable to bring my blood sugar down with a reasonable "diet" and was bewildered because I thought I was eating correctly.  I had started using a treadmill and lost about 8 lbs, but still had elevated blood sugar.  After reading a book by David Mendosa (he also has a website) which said carbs drove the blood sugar up, I gave up potatoes, rice and most bread and saw a distinct lowering of my readings.  I tested several times a day (a serial tester!) and figured out a diet which has kept my blood sugar near normal.  In the spring Bernstein's book was recommended by another member (fergusc) which was enlightening to say the least.  According to Dr. B., our problems with cholesterol is not from the meats or butter that we eat but from the carbs because our own bodies produce cholesterol.  (My cholesteral dropped 40 points in 5 months, after cutting out the carbs.)  I also use Smart Balance with flax seed oil because it's a great substitute and tastes good, but I use butter, too.  Of course, butter has calories, so you have to factor that in if you're trying to control weight.  In any case, losing weight is much easier and faster when the carbs are taken out of the diet and it's even more accelerated when you exercise regularly, too.  What has kept me on track is the glucose monitor because I never want to see high numbers again, or put the 30lbs I lost this year back on.  When you change your eating plan, be careful about testing since you are on medication.  And it's probably a good idea to inform your doctor, too.  Please read through some of our past topics and you'll find lots of encouragement and help.  Take care. 

Marburg,

That's great! I am having kind of the opposite effect right now. My bg readings have been going up the last several days...I think my system has finally rid itself of the glyburide and now is adjusting to the Januvia. At least I hope that is what is happening. To keep from giving in prematurely and going back to the glyburide I've decided to not take any readings for awhile. I ordered Insulow and Evening Primrose and when those arrive I'll start those and give that a few weeks and then check to see what's happening. I also seem to be at a standstill with the weight loss. But since I've lost 40 lbs. I guess that a plateau should be expected. I'm really trying to practice patience. My doc was not supportive of the Januvia so I really want this to work so I can go, "Nah nah nah nah nah."

Gelchick told me the same thing which is why I'm trying to exercise patience...something I'm not always good at. But I'm trying. :)

Just my 0.02 here

I am still seeing the same good results with Januvia. In fact, I have been doing the happy dance here for the last week bec my average bg has decreased yet again.

I recently had to find a new dental provider because of an insurance change. My new guy is younger and has a lot of diabetic patients (one reason why I chose him). He has all of his diabetic patients that have any kind of gum issues (and mine were very minor - no true gingivitis, very minor inflammation) undergo a deep cleaning where they numb you and clean under the gum line. We also decided to remove my last wisdom tooth in anticipation of replacing my current bridge with a sturdier partial plate (I had some back teeth smashed in an auto accident 35 years ago- and they are really weak now.). It turns out that there was an ongiong low grade infection in the tooth- It never showed up on any x-rays and never bothered me. So he sterilized the pocket and I took antibiotics for 10 days to clear up any remaining infection- so here's the good part

after 3 days on the antibiotic, I noticed that my usual 90-95 AM reading dropped to 87-91. My daytime readings dropped from mid- to high 80's to low 80's. My exercise numbers dropped from high 70's - low 80's to low to mid-70's. It is now 14 days after my extraction (4 days off the antibiotic) and my numbers continue to sit at the lower end of my new range. And they are as steady as before.

I am tempted to cut back on my meds- but I think I'll stay like this, until I go for my A1c at the end of November- I'm sure it will drop again if this keeps up and my doctor will be all on board with cutting some meds. I'm hoping to cut the Januvia in half and drop the Metformin by 1 dose.

sandy