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glyburide vs. Januvia?

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Posted 10/26/2007 5:00 PM (GMT 0)
Sandy,

Did your bg go up at first as your body dumped the glipizide?
Posted 10/26/2007 5:09 PM (GMT 0)
That really is great Sandy! My bg readings are still declining but I've begun to notice some stomach discomfort and nausea. It could be the increased sinus drainage from the Januvia causing it, or it could be my GERD acting up. I've just have to wait and see.

Marburg
Posted 10/26/2007 6:27 PM (GMT 0)
Karen

I stayed on glipizide for 3 weeks when I started Januvia. I was splitting a 5 mg tablet of glipizide and taking it AM and bedtime, so I started by taking 1/2 pill of glipizide in the AM and Januvia at night- as soon as my number started to go consistently lower (about 2 weeks) I dropped the glipizide every other day for a week- then stopped it altogether. Looking at my records- I wobbled quite a bit from 60's - 120's during that time (which was typical with the glipizide bec I was forever having to eat carby stuff to keep my bg up- then I'd overshoot and go up to the 120s) then stabilized in the low 100s, then dropped to my previous range after about 3 months.  I stayed there from July until my dental work. My A1c was 5.0 in July and I'm going again the 3rd week in November.

The thing I really love about Januvia is the consistency in my numbers. I believe that Bernstein is correct when he says we should keep a tight range on the numbers as well as keeping them in a non-diabetic range. I think that our messed up biochemistry makes it difficult for our bodies to make the proper adjustments when we throw food at it or exercise, or even sleep (Dawn Phenomenon), so it is in our best interest NOT to do things which are too challenging. So even when my numbers were in the low 100's, I was happy because they were ALWAYS in the low 100's. I am now content to always be in double digits. I know that my A1c is a true reflection of the stability of my control, not just a pretty average of high and low numbers that makes it seem like my control is better than it really is. Now, I could be totally out to lunch here, but I feel best when I stay stable ( high or low- it doesn't really matter- but stable eyes

sandy

 

Posted 10/26/2007 6:38 PM (GMT 0)

Marburg-

I hope that the Januvia isn't the cause of your distress. Do you have seasonal allergies that contribute to your sinus problems? I have stuffiness off and on from the end of summer until the first frost- but I can't relate it to my taking Januvia- I'll pay attention in the winter when I am usually allergy free. I have only had acid reflux at the end of my first pregnancy because I carried so high and didn't drop until I was in actual labor- I don't envy you. My diet is very alkaline, so I tend to neutralize acid not compound it. That's one good thing about eating a lot of raw foods.

Hope you feel better soon,

sandy

Posted 10/26/2007 7:23 PM (GMT 0)
Sandy,

Yes I have year round allergies that cause nasal drainage. But since Januvia I've had an increase in the drainage. My GERD is usually under good control unless I'm under stress which I am under a lot of right now with a change in meds and the anniversary of my parents passing. I do think the Januvia might be contributing to a worsening of the symptoms but so far I am able to tolerate it. Also, it may have something to do with Flu Shot. I had one yesterday and that's when I really began to notice the symptoms getting worse--the nausea. I have a slight allergy to eggs and a big allergy to sulfa so I always get sick from a Flu Shot (but don't get the flu).

Thanks Sandy,
Marburg
Posted 10/26/2007 7:47 PM (GMT 0)
Sandy and Marburg,

Thanks for all your input into this. Like I said my doc didn't want me to go on it, gave me 10 weeks worth of samples saying that should be enough to tell if it's going to do anything and that was it. Never any reason why other than she had only had one patient use it with little results (and how long did they use it?) and she had talked to docs at diabetes conferences that didn't like it. That really told me a lot (not!). I just said I wanted to try it anyway. She said if that didn't work we could try some other drugs like Amaryl (doesn't that do the same thing as glyburide?). I had too much trouble with Actos and edema so won't go that route again. Ahhh, figuring out our own course of treatment is such great fun. Sandy, I'm with you on the steady bg numbers. Since both lows and highs are dangerous I go for the middle and staying there.
Posted 10/26/2007 7:51 PM (GMT 0)
I totally agree with the steady numbers. I am seeing that and bg's going down. So, if I'am seeing side effects perhaps they will go away with time.
Posted 10/30/2007 8:12 PM (GMT 0)
Well--the stomach issues may have been related to low potassium or vitamin B or my stomach getting used to Januvia. Anyway, I ate a banana last night took a vitamin B supplement (and did it again today) and haven't had as much trouble with my stomach. Numbers are still going down. Ave is now at 127 for the month and 115 for the week.

Karen, are your numbers still going up?

Marburg
Posted 10/30/2007 8:52 PM (GMT 0)
Yeah, the numbers are still climbing...hitting in the 160's. So, I'm adding back in half of the glyburide for the time being and a little more metformin. I'm still keeping with the Januvia in hopes that if nothing else at least I won't have to take as much glyburide. I was on the met/glyburide for a lot of years, so it may be that I don't have enough cells left for the Januvia to do the job on its own. I'll keep trying tho'. I'm glad your stomach is getting better. Occasionally the metformin causes some issues with my stomach. Imodium and I are on a first name basis. :)
Posted 10/31/2007 1:53 PM (GMT 0)
Hi Karen,

I'm sorry to hear your numbers are still going up. My doctor did say that when she takes me off Actos it will go up for awhile and then should level off and start going back down. She said the whole process (starting Januvia, stopping actos, and stablizing) should take about 6 months. So, hopefully it will turn around for you.

As for me, I'm continuing to see good numbers. I am still taking metformin and Actos, although I'll probably be reducing the Actos to 15mg from 30mg soon (end of Nov). I never really had stomach issues with metformin but I am having them with Januvia. I really think it has to do with the increased sinus drainage which aggravates my GERD/gastritis. Hopefully it goes away completely.

Let's hope your numbers come back down.

Sandy, how are you doing?

Marburg
Posted 10/31/2007 3:00 PM (GMT 0)
Hello Marburg and Karen

Glad to hear you are doing so well. Thanks for asking! I am fine as frog's hair as my uncle used to say. My post tooth numbers are staying stable and low. I'm hoping it will be enough to knock me down a notch when I go for my labs in 17 days. I'm sure my doc will want to take my meds down because my A1c last time was 5.0 and she was making noises to that effect then- but I wasn't sure that the good result wasn't a fluke. I'm unsure if I'd rather lose some of the Januvia or some of the metformin. I may ask her what she thinks of Glumetza- the new extended release form of metformin- my numbers are low all day long, my biggest problem has been my Dawn Phenomenon and it sounds like that might help with the overnights- so I'd opt for the glumetza and the Januvia if she's agreeable.

I hope your sinus problem resolves itself soon- now that we've had our first frost- my allergies are gone- but they affect my eyes more than anything else, so I can use powder eyeliner and regular (not waterproof) mascara again. 

Karen,

I hope your numbers come back down soon. Does the glyburide help you? Glipizide made me crash a lot and I was on the smallest dose cut in 1/2- so my doctor figured I have plenty of pancreas function, and you have to have well behaved beta cells for Januvia to work. It doesn't stimulate your cells to make more insulin, but it helps your insulin stay around longer. So if you don't make enough, Januvia won't help you alone. Maybe you need the glyburide to get the insulin production up and then Januvia to stabilize it..just some random thinking there....

sandy yeah

Posted 10/31/2007 3:42 PM (GMT 0)
Sandy,

That was my thinking, too. The glyburide does make me dive a bit so I do have to watch it. I find that if I start a dive a fiber rye cracker with some peanut butter stops it without spiking it back up high. Like I said, I will keep playing around with this and I so appreciate yours and Marburg's input. My doc gave me no direction on this so am playing around with it myself. At least with the half dose of glyburide my numbers are back down to good levels. What a rollercoaster ride!
Posted 10/31/2007 4:46 PM (GMT 0)
Sandy,

Glad to hear you are doing so well. Karen, I'm glad your numbers are back down. Let's keep comparing our numbers--the input from you both have really helped me. My next A1c is at the end of Nov. I hope I'm back down to where I was before the summer started.

Marburg
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