How soon does Sitagliptin work?

[Jude]

Am on Humalog 25, Metformin and for the past 18months Byetta as well. However, Byetta did not help me lose the weight that the insulin has put on and I felt unwell most of the day so stopped the Byetta 8th August and then my bgs started rising. Two weeks ago my DSN started me on Sitagliptin 100mg which I have been taking early evening after my meal. So far I have not had any improvement in my numbers and am wondering if this is normal or whether the Sitagliptin is not working for me??
Today DSN and I decided to leave things as they are for now and see how things are in 3-4 weeks time following my holiday.
Thanks for any help.

[BaliRob]

I have 'bumped' this up because I am sure there are many of us that would like to know. Me, especially, as my doctor is considering this med amongst others soon

[xyzzy]

From http://www.phlaunt.com/diabetes/18538604.php which an inner page of the excellent Blood Sugar 101 site that has an amazing amount of information.

Januvia is a diabetes drug that works by increasing the levels of GLP-1, an incretin hormone that stimulates insulin secretion. Another diabetes drug, Byetta, is an artificial, injected, form of GLP-1. Januvia is quite different. It is a pill that causes the GLP-1 your body secretes on its own to rise to a higher than normal level by inhibiting the action of DPP-4. DPP-4 is an enzyme (a.k.a. protease) which when it is left to its own devices, chops up GLP-1 and another hormone, GIP. When DPP-4 is inhibited, GLP-1 does not get chopped up and remains active in the body. When GLP-1 is active, it stimulates insulin secretion when blood sugars rise.

[Jude]

XYZZY Thankyou. However I am very - you have quoted the science behind the sitagliptin which is fine but I still do not know if my current experience of the drug is normal or whether I am taking a drug which is not helping!!

[BaliRob]

Dear xyzzy,

I read and tried to understand the tech info you supplied as a link. I am afraid that it did nothing for me except to frighten me off.
I suppose that was your intention and I am grateful for that.

Why, except for Insulin and Metformin, are all the other diabetic meds fraught with danger?

Regards,

Rob

[Sid Bonkers]

In lay terms Sitagliptin works by asking the pancreas to work a bit harder when carbohydrates are present in the blood, unlike Glic it does not force the pancreas to work harder all the time, so in effect it is a SMART drug.

I didnt understand the other answer either

[BaliRob]

Thanks Sid - thought it was me.

Your precis made much more sense.

[catherinecherub]

Hi Rob,

If you do decide on Sitagliptin, make sure your Dr. is aware about prescribing a smaller dose for people with renal impairment.

http://www.medicalnewstoday.com/articles/243439.php

How it works in your body, (in glorious technicolor).

http://www.januvia.com/sitagliptin/janu ... -sugar.jsp

[Fides]

First took about two weeks for the medications to start getting in balance.

Sitagliptin was a lifesaver for me, bout 2 years ago, I got really ill, largely due to the heating system at work causing massive dehydration, my diabetes control deteriorated and it seemed my pancreatic function was not working properly, finger pricks were in the 20s.

Then I got put on 9 pills per day instead of 4, I got Sitagliptin and double doses of metaformin and glycozide.

All I can say is wow, without the sitagliptin my bloods were incredibly high despite following a low calorie/carb diet (lighterlife).

Sitagliptin I was told can cause cancer or increase heartattack, I forget, please check the facts rather than rely on my memory, but with the introduction of sitagliptin they increased my metaformin to shield against the side effects of Sitagliptin.

2 years later, been getting really low blood sugars...

Tried changing meds, tried dropping sitagliptin, that doesn't work, about the best is to reduce glycazide by 2 each day 1 in morning and 1 in evening.

I take 1 sitagliptin in the morning together with 1 metaformin and 1 glycozide, (supposed to take 2 glycozide, but atm my sugars are going lower and lower so 1 seems to work)

For lunch I take 2 metaformin and for supper I take 1 glycazide and 1 metaformin.

Sometimes during the day my bloods get rly low and I have to bump them up then I have to take the other glycozide for the evening and the next morning, i.e. 1+1

[swimmer2]

I have a current Sitaglyptin prescription although I'm not using it at the moment (because I'm back on the basal insulin). From my limited expose to it I would say that it lowered my overall numbers a little but the main effect was to dampen out the spikes. Unfortunately for me this meant that my levels stabilised at too high a level (8-9) so it wasn't a suitable replacement for the insulin.

I've heard, however, that its a well regarded drug and it didn't give me any side effects.

[BaliRob]

Catherine - The Januvia web site (your 2nd link) says, "Do not take Januvia if allergic to Sitagliptin". As Januvia IS Sitagliptin this is another absurdity, apart from the very serious possible side-effects, which go to put me off using it.

Thankyou for watching out for me and remembering my kidney problem.

Swimmer thanks for your post - but you may not have kidney problems??

Fides - thanks for your contribution.

I do not know whether we have been able to help Jude (OP) - I do hope so.

[swimmer2]

Swimmer thanks for your post - but you may not have kidney problems??

You're correct, I don't have any evidence of kidney problems. By saying it was well regarded, I meant in comparison to drugs that try to push your pancreas harder which I believe this doesn't - that's all.

[BaliRob]

Swimmer I understand - thankyou

[Unbeliever]

Sitagliptin was a Godsend for me as I suffered badly from enormous spikes in the evenings because I don't like to eat very much at my evening meal. Sitagliptin took about 2weeks to kick in and enabled me to drop the 3x2mg of glimepiride i was taking almost immediately. I saw this as an acceptable trade-off for any problems which it muight cause in itself.

My main fear with it has been that because it is a faairly new drug the long term effects are noy yet known but none of them are without risk IMHO.

I was not aware that there was the option of a smaller dose catherinecherub. I thought there was one standard dose of 100mg.

Sitagliptin does not cause weight gain which the glimepiride did but did give my hypos in conjunction with the glimepiride.

The consultant was amazed at the speed with which it worked on me - I was less amazed because my own bg readings clearly demonstrated that my redings were generally very good bu my small evening meal {low carb, low GI] generated spikes of 18plus.

Hope this helps Jude. The consensus seems to be that it takes about a fortnight to kick in has few side effecs but definitely works best in ironing out spikes so you should try taking it at the time you expect to spike. Apparently it doesn't work unless and until it is needed.

Fides I know what you mwean about having to adjust the time you take your drugs . It is all a matter of balance and it necessary in my opinion. I work hard at achieving a balance between food exercise and medication. Of course in order to do so regular tesing is necessary.
Unfortunately it is not generally understoof by all HCPs that his is possible or advisable. It is only what many people have to do with insulin after all .

Regarding xyzzy's posts about sitagliptin , I don't think he would have been rying to put anyone off using it - I should think he was only trying to provide information. I say this because i remember that he once wanted his own GP to prescribe it for him.

Personally , given a choice, I would prefer not to take any drugs- even those supposed to have beneficial effects. Unfortunately, I do no have that choice so try to take as few as possible . Diet and exercise are not enough by themselves for many of us but are always a useful part of anyone's diabetes control.

[BaliRob]

It was the information about the drug that was frightening and I, for one, know that xyzzy was only trying to help - which he did.