glyburide vs. Januvia?

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tutorgirl
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Date Joined Aug 2007
Total Posts : 235
   Posted 9/9/2007 11:12 AM (GMT -7)   
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

gelchick
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Date Joined Aug 2006
Total Posts : 477
   Posted 9/9/2007 12:50 PM (GMT -7)   
Hi tutorgirl
 
I swapped glipizide (a sulfonylurea like your glyburide) for Januvia back in April. I have never been happier- I no longer have to eat carbs to keep my bg from dropping unexpectedly into the low 60's. It took about 5 weeks for it to come up to full effect, but I saw stabilizing bg levels almost immediately. I no longer have to fight weight gain. I have had no side effects and I do think that my mood has been consistently better since starting Januvia. I feel happier and no brain fog. I have a good amounts of energy.
 
Januvia works best for people who still have reasonable pancreatic function. (It doesn't work for type 1s). It help you to use the insulin you make better, and I think it also helps your liver not to kick out too much glucose. It has tamed my Dawn Phenomenon better than metformin alone and my recent A1c of 5.0 was my best ever.
sandy
I just want to live happily ever after-every now and then. Jimmy Buffett


Roberto
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Date Joined Sep 2007
Total Posts : 3
   Posted 9/11/2007 7:57 AM (GMT -7)   
I was swiched from Glucophage to Januvia. Results: more side effects no real change. I finally quit using it.

Marburg
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Date Joined Mar 2006
Total Posts : 486
   Posted 10/12/2007 7:54 AM (GMT -7)   
Hi Karen and Sandy,

How is januvia working for you now? My doctor just added it to my meds with the hope of being able to take me off Actos in the near future. Did you have any side effects? If so, what kind and how long did it last? Have you seen any weight loss after not taking Avandia or Actos or the other sulfonylureas? Did the water retention go away?

Thanks

Marburg

gelchick
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Date Joined Aug 2006
Total Posts : 477
   Posted 10/12/2007 8:09 AM (GMT -7)   

 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


I just want to live happily ever after-every now and then. Jimmy Buffett


Marburg
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Date Joined Mar 2006
Total Posts : 486
   Posted 10/12/2007 8:50 AM (GMT -7)   
Thanks Sandy,

I'm glad to hear Januvia is working well for. I've really been struggling with my bs for the past several months. I had been on Avandia for 2 years when my doctor took me off it because of the heart associated risks. While on Avandia I had fluid retention and gained 40 pounds in 2 years. I've been on Actos since and have gained 20 pounds in 2 months along with fluid retention (milder than when on Avandia). My bs readings while on Avandia were doing pretty good, but on Actos it's almost like it was when I was first diagnosed 3 years ago.

I never associated my sinus problems with either Avandia or Actos. I probably should have since I have had sinus infections repeatedly since being on Avandia or Actos for the past 2 years.

My doctor wanted me to start on insulin or byetta but I really don't want to go that route for as long as possible. I'm really hoping that Januvia works for me.

Anyway, Sorry for the long post--I'm just frustrated.

Thanks for your response--it was very helpful.
Marburg

tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 10/12/2007 10:12 AM (GMT -7)   
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
===================
>Karen<
~Forum Moderator/Diabetes~


Marburg
Regular Member


Date Joined Mar 2006
Total Posts : 486
   Posted 10/12/2007 11:18 AM (GMT -7)   
Hi Karen,

I just started with the Januvia today. So far, I did notice that after eating my numbers are lower but then about 4 hours later they start creeping back up. But, this is only day 1.

Your experiences do sound a lot like mine. I'm not a good candidate for Byetta because of Chronic gastritis (I was rejected as a test candidate because of that). And I really, really don't want to go that route for as long as possible. I have changed my diet dramatically over the past year (no breads, very little rice or potato (as in once in a great blue moon)). I have been under a lot of stress for the past couple of years and it really peaks between Aug-Nov. Still until I went on Actos I had decent bs readings. On Actos my numbers went haywire, peaks and valleys, mood swings, swelling, etc. And sinus infection after sinus infection. I'm still taking the metformin and I'm hoping to get rid of the Actos.

I agree, lets update in a month and see how the Januvia is doing. My doctor says that she's had a lot of patients who have had good responses with it.

Marburg

gelchick
Regular Member


Date Joined Aug 2006
Total Posts : 477
   Posted 10/12/2007 11:23 AM (GMT -7)   

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 


I just want to live happily ever after-every now and then. Jimmy Buffett


Marburg
Regular Member


Date Joined Mar 2006
Total Posts : 486
   Posted 10/12/2007 11:51 AM (GMT -7)   
Thanks Sandy,

I am going to stick with the program and see how it goes. I go back to the doctor in 2 weeks to see if there's been any improvement or if the swings are getting worse. I took Actos for 8 weeks so we're still staying with it for the time being in addition to the Met and Januvia.

Marburg

Marburg
Regular Member


Date Joined Mar 2006
Total Posts : 486
   Posted 10/18/2007 1:35 PM (GMT -7)   
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

gelchick
Regular Member


Date Joined Aug 2006
Total Posts : 477
   Posted 10/18/2007 2:21 PM (GMT -7)   
YAY! I must have escaped the nose dripping-and I am thankful. I hope your numbers continue to improve.  sandy
I just want to live happily ever after-every now and then. Jimmy Buffett


tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 10/18/2007 8:01 PM (GMT -7)   
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.
===================
>Karen<
~Forum Moderator/Diabetes~


Marburg
Regular Member


Date Joined Mar 2006
Total Posts : 486
   Posted 10/19/2007 7:03 AM (GMT -7)   
Thanks Sandy. I hope they keep improving also.

Karen, I totally agree with you about the hypos and the spikes. I've noticed that I'm not having the early evening spikes I used to have. However, my numbers in the morning are higher but overall I'm seeing a 20 point decline after 1 week. I sure hope my numbers keep getting better.

Also, the fluid retention I had with first Avandia and then Actos (after switching from Avandia) appears to be gone. I'm also seeing a decline in appetite. I'm hoping that means I'll lose some weight.

Marburg

soakbear
New Member


Date Joined Oct 2007
Total Posts : 3
   Posted 10/21/2007 3:34 PM (GMT -7)   
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

soakbear
New Member


Date Joined Oct 2007
Total Posts : 3
   Posted 10/21/2007 3:39 PM (GMT -7)   
OOPS! It was 11 YEARS ago, not months! (SMILE)
Barbara in Alaska

tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 10/21/2007 4:18 PM (GMT -7)   
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. :)
===================
>Karen<
~Forum Moderator/Diabetes~


soakbear
New Member


Date Joined Oct 2007
Total Posts : 3
   Posted 10/21/2007 8:45 PM (GMT -7)   
Thanks for the welcome Karen! (SMILE)
 
I also have Polycystic Ovarian Syndrome and was always the heaviest of the seven children in my family growing up. I only had one child and she was obese as well and ended up getting gastric bypass surgery last year. She is doing well now and lost over half of herself. Hopefully she will never have the problems that I have healthwise!
 
I have tried so many diets my whole life that I am pretty sick of "diets." I just try not to eat many carbs, (sorta like the Atkins or South Beach diets) and hardly ever have fruit or breads. I do occasionally eat rice and potatoes. We gave up butter because my husband is now fighting his cholesterol. We eat Smart Balance Light spread. We eat meats, eggbeaters and occasionally eggs, and I drink non-fat milk if I have milk. I found Dreamfield's Pasta which claims low carb. It is such a chore for me to change my cooking style... I do try and we have a few new recipes now, but it just gets so frustrating. We do eat a lot of tomatoes, onions, garlic, beans and mostly good veggies like green beans and broccoli. We hardly ever eat dessert, and anymore if we do eat dessert we go for Breyer's Low carb ice cream bars or high fiber cookies or such. We go through phases though where it seems like we get carb cravings.
 
I know I do not get enough exercise as well. I have low back pain when I walk lately. It stops if I rest for a couple of minutes but is back in a couple of minutes when I start walking again. It just makes it hard to want to walk much. I am already on anti-depressants. Without them I cry all the time! Having diabetes can be very depressing after so many years!
 
I have a good attitude actually though! (SMILE) I try to make the best of everything no matter how frustrated I get. I am excited about the new things they are discovering about diabetes recently, and when I did use Byetta it seemed to work somewhat. Now Januvia seems to work as well! Was a runny nose a side affect? I forget - but I sure have had a sorta constant feeling like I have a runny nose....
 
I have always suspected that the obesity problem in America has to do with all the children raised on corn syrup formulas in the 1940's to 1960's. After that came soy I think. Now it's hard to find products without corn syrup - I actually think I am allergic to corn and corn products. But that's another story.... (SMILE)
 
Again, thanks for the welcome! I hope to visit here often. (SMILE)
Barbara in Alaska
 

LanieG
Forum Moderator


Date Joined Nov 2006
Total Posts : 3911
   Posted 10/21/2007 9:38 PM (GMT -7)   
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. 
yeah
Lanie
forum moderator - diabetes
 
"pre-diabetic" controlled so far by diet and exercise
following low/no carb diet, no meds


Marburg
Regular Member


Date Joined Mar 2006
Total Posts : 486
   Posted 10/25/2007 10:40 AM (GMT -7)   
Just got back from my initial doctor's visit for Januvia. At 2 weeks, my bg readings are down 50 points and I've lost 7 pounds. For me, I'm seeing an additional benefit of Januvia. The actos makes me retain fluid and I have bouts of diarrhea. It appears the Januvia makes me flush out the excess fluid and the diarrhea is gone. My next checkpoint is in 1 month. If my numbers keep improving I may get to ditch the actos!

Marburg

tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 10/25/2007 11:39 AM (GMT -7)   
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."
===================
>Karen<
~Forum Moderator/Diabetes~


Marburg
Regular Member


Date Joined Mar 2006
Total Posts : 486
   Posted 10/25/2007 12:58 PM (GMT -7)   
Hi Karen,

My doctore did say that it would take months to get the full benefit of Januvia. She also said that she has seen some good results. I do agree that you might be seeing an increase because the glyburide is now completely out of your system. She said that when we finally get to a point where I can ditch the Actos the same thing would happen - I would see an increase for awhile and then it should go back down.

Have you tried bitter melon supplements (capsules the tea tastes nasty). It does help in a pinch. It's also called charantea. Let me know how the Insulow and Evening Primrose work.

You can jump start the weight loss plateau by doing 10 jumping jacks or sit ups a day (at least that worked for me when I dropped 50 pounds a number of years ago).

Marburg

tutorgirl
Regular Member


Date Joined Aug 2007
Total Posts : 235
   Posted 10/25/2007 2:17 PM (GMT -7)   
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. :)
===================
>Karen<
~Forum Moderator/Diabetes~


Marburg
Regular Member


Date Joined Mar 2006
Total Posts : 486
   Posted 10/26/2007 9:26 AM (GMT -7)   
I fully understand. Hmm...for the past week now I've been noticing some mild stomach discomfort (pain?) in the area where I have gastristis and mild nausea. I can't tell if it's because of the increased sinus drainage, GERD, or Januvia. My guess is it's the sinus drainage and Januvia. I'll be patient and see if it goes away. The website said that it was a fairly common side effect (2.3%) and that it should disspate over time.

Marburg

gelchick
Regular Member


Date Joined Aug 2006
Total Posts : 477
   Posted 10/26/2007 10:08 AM (GMT -7)   
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
I just want to live happily ever after-every now and then. Jimmy Buffett

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