Type 2 Puzzled on januvia

[GwynethLamont]

Hi all,

I have been following low carb diet for a couple of years now and have just been put on januvia in addition to 2500 mg metformin daily. I have noticed that there is little effect on my bg levels unless l do actually eat some carby food. A couple of times l had a small scoop of ice cream and next day morning levels were in the 90s (US) ie normal instead of my normal range of 120-130.
Am I imagining this, or do I actually need some sugar in my diet to produce an effect?

 

[Guzzler]

Hello and welcome. Just to clarify, you are on Januvia (Sitagliptin) and Metformin but these are drugs used for the treatment of Type 2 Diabetes. There is a Type 1 banner on your thread title.

It is important to know which type you are so members can advise you fully.

 

[DCUKMod]

Hi all,

I have been following low carb diet for a couple of years now and have just been put on januvia in addition to 2500 mg metformin daily. I have noticed that there is little effect on my bg levels unless l do actually eat some carby food. A couple of times l had a small scoop of ice cream and next day morning levels were in the 90s (US) ie normal instead of my normal range of 120-130.
Am I imagining this, or do I actually need some sugar in my diet to produce an effect?

Hi Gwyneth - Your thread suggests, by it's prefix, you arre asking about Type 1. Are you T1 or is that a slip of the finger? If it's an error I can fix it for you.

 

[Daibell]

Januvia (Sitagliptin) is only used for T2s. It is a DPP4 inhibitor which means it inhibits an enzyme which in turn normally switches the pancreas off from producing insulin after a meal. This means that you now have insulin produced for longer. It only works if you have higher blood sugar so, for example, it doesn't cause hypos. The drug helps reduce sugar spikes but only spikes.

 

[GwynethLamont]

Hi Gwyneth - Your thread suggests, by it's prefix, you arre asking about Type 1. Are you T1 or is that a slip of the finger? If it's an error I can fix it for you.

Oops. Had thought it was going in “ask a question”. I am type two as in still producing insulin but insufficient. Always been on thin side and no other indicators of metabolic syndrome so endo thinks probably not insulin resistant, and thinks drugs other than these two would send me hypo. Just seems strange to me if to reduce my overall glucose levels I seem to actually have to eat dessert.

 

[DCUKMod]

Oops. Had thought it was going in “ask a question”. I am type two as in still producing insulin but insufficient. Always been on thin side and no other indicators of metabolic syndrome so endo thinks probably not insulin resistant, and thinks drugs other than these two would send me hypo. Just seems strange to me if to reduce my overall glucose levels I seem to actually have to eat dessert.

No worries. I've tweaked your title to show Type 2.

 

[DCUKMod]

@GwynethLamont - Have you had the additional tests to confirm your diabetes type at all? You're certainly atypically T2, but that doesn't mean you aren't.

 

[EllieM]

@GwynethLamont - Have you had the additional tests to confirm your diabetes type at all? You're certainly atypically T2, but that doesn't mean you aren't.

Definitely confused here. I thought insulin resistance was the defining thing for T2. If you're just not producing enough insulin you'd be T1 or LADA????
(There again, diabetes is a weird and not so wonderful thing and I sometimes think that every diabetic has their own unique and different form of it.)

 

[satindoll]

Definitely confused here. I thought insulin resistance was the defining thing for T2. If you're just not producing enough insulin you'd be T1 or LADA????
(There again, diabetes is a weird and not so wonderful thing and I sometimes think that every diabetic has their own unique and different form of it.)

A popular misconception, t2's can be non-producers and insulin sensitive at the same time......

 

[GwynethLamont]

A popular misconception, t2's can be non-producers and insulin sensitive at the same time......

Diagnosis is type 2, as not insulin dependent. Endo says it is a multifactorial disease so I guess it is a pretty broad church. According to my family history my variety probably has strong genetic component rather than lifestyle. Anyway, I’m hoping he is treating the person and not any one label.

 

[DCUKMod]

Definitely confused here. I thought insulin resistance was the defining thing for T2. If you're just not producing enough insulin you'd be T1 or LADA????
(There again, diabetes is a weird and not so wonderful thing and I sometimes think that every diabetic has their own unique and different form of it.)

My personal belief, Ellie, is that diabetes is a bit of a continuum, with many other side factors in play at any given time. There are so, so many atypical bods on here for almost as many reasons are there are folks, when taking other factors into account.

I'm not fan of labels, and attempting to put people into polarising labelled boxes for T1 and T2 can be exceedingly unhelpful, but I understand how it comes about. Where individuals are not clear cut, in terms of their type, it really is incumbent upon them to ensure they seek and achieve decent care. All too often people not doing too well are assumed to be non-compliant in some way, when that's not always so.

 

[Daibell]

A popular misconception, t2's can be non-producers and insulin sensitive at the same time......

Not sure I agree. If you are not producing insulin and slim etc then you may well be defined as 'T2', as I am by guesswork by my GP, but I fit the LADA profile and T2 is not the right category for me and possibly the OP. There is a lot of confusion on this but to be in the same category (T2) as those with insulin resistance and producing too much insulin is not useful when you are doing the opposite and not producing enough insulin. The causes are different and so is the treatment.