Insulin with added Januvia (Sitglptn) study

[raffajaffa]

https://clinicaltrials.gov/ct2/show/NCT00395343

Im in for my Doctors meeting in the morning due to the usual poor control.
Expect hba to be double figures.
Having uppted the Levimir and Novorapid to 65/50 units per day I have had a
slight improvement in readings.ie 8.3 to 11.9 which might sound horrific to some
casual readers here.
Whilst I have a deep understanding as to where and why my results are poor.
Theirs far more to it than carbs?

I wonder if anyone determined enough can read through this report and see if
they have a better understanding of it.
ie Is it worthwhile to try going back on Januvia now that I am heavily reliant upon
insulin.
Previously this was a no no.? Looks like this has changed..
Also am I reading it correctly..Study did not include anyone taking the
fast acting insulins.

Thanks in advance.

Sorry Title it should read Januvia

ps One comment for the "We are all different" brigade".
You should add that we very often never the same at a number of times
within a small time period.ie your liver does switch on and off at times in processing insulin.
Similair the pancreas production is not a linear process.

 

[Daibell]

Interesting. The report implies that Sitagliptin does help reduce BS when added to insulin. This really surprises me. Sitagliptin is a DPP-4 inhibitor which works by suppressing the DPP-4 enzyme which in turns stops pancreatic insulin output a certian time after a meal. Now T2s who are overweight with insulin resistance (the study doesn't give the patients BMI) will already have too much insulin of there own unless really advanced and the pancreas has given up. Hence extending production with Sitagliptin in theory should achieve very little. So, we need more information on the BMI of the patients and how long they have had diabetes etc. Despite this I remain surpised by the result.

 

[Lamont D]

We've been here before with this drug.
It has changed my life and the way it works it doesn't surprise me that it didn't work alongside Insulin.
The extra insulin it creates by stimulating the pancreas and hence lowers glucagon and glucose levels.
Hence lower blood glucose readings.
There is a chance that I could higher my carb intake as suggested by my docs but that's why I having more tests. To see if I can.

 

[raffajaffa]

quick thanks for the replies.
Not sure if Nosher is quite in agreement that the report indicates it DOES work with Insulin.?
Also not sure whether my surprise at reading this semi contradictory review was a case of."I dont believe it" or "Yet again
they have gotten something wrong for years?" and " Is it worth another try? as I am now in the area of "well lets try something
different as you do not appear to be in the normal DB arena."
ie Cut the carbs and you are sure to get lower readings.Been there many times and got the T shirt.
That is why I wrote the poem.Maybe I should write one called Carbs just pass thru me.?
Obviously this is only the tip of the iceberg as there is more going on,ie actions and reaction with any medicines.
Will discuss with Doc in the morning when I can view the latest results including any self produced insulin indicators?
(This I doubt at 115 units injected per day and still nowhere near enough...
She is already a bit dizzy at me bringing up so many contradictory reports
as to what can happen with diabetics.

 

[raffajaffa]

HBA1c @ 9.3 unchanged from previous despite increase so perhaps another Canaries holiday triggers this.

Not going down added Januvia route as its easier for me to keep the very little control I have without any complications.
thanks.