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Sitagliptin or pioglitazone - that is the question !

A

ashtree

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:wave: Hi first time on this forum. T2 for 2 years, on metformin sr 500mg a day as I cann't tolerate higher dose. 48 now and over weight but cann't shift it. Hba1c increasing. Option now from my practice nurse is to ad in sitagliptin or pioglitazone. Don't wantto put any weight on! Prescribing GP favours pio. Would appreciate any advice / experiences.
Thanks A
 
I would go with the GP, especially if they are the diabetic lead in the practice. My GP is the diabetic lead in the practice, therefore he is the one who knows what works with what, etc.

It can be a trial and error thing to find right dosage and which tablets to take, but the only thing that will help (as I keep being told) is weight loss.
 
Hi. I disagree and would go with the Sitagliptin. I was offered Pio 2 years back but refused as it can cause fluid build-up with some weight gain and is not ideal for heart conditions. Sitagliptin has few sins for most people, although by exception it can cause pancreatitis. I've been taking it for 2 years now and only had light headaches for 2 weeks. Are you on Metformin SR, the Slow Release version? If not suggest to your GP that you change to that and increase the dose. It won't have a dramatic effect on your sugars but every little helps. Are you low-carbing to help weight reduction? This should take priority over any medication.
 
An interesting question.
I was given Pioglitazone last month. This was after I requested to be taken off of Januvia due to the risks of cancer.
My friend works for a law firm in New York and is dealing with those involved in a class action against the manufacturers of Januvia, so although there is only some medical information linked to potential cancer risks, I am not willing to chance it.

According to my GP, there is very little oral medication left for me to try as I appear to be someone who gets side effects easily!
Pioglitazone became my daily medication along with SR Metformin.
Result? A weight gain of 10 pounds in four weeks. No change to my diet and exercise. I did not see any improvement to my levels.
So, back to the doc on Monday of last week.

The rapid weight gain did not surprise him and agreed with me that it appears to be counter productive to take a drug which is known to cause weight gain when losing weight is the ideal scenario! No more Pioglitazone for me.

I was prescribed 5mg Forxiga.
Levels have already improved with numbers easily falling to Nice guidelines.
Side effect so far is the need to pee frequently. So that required a bit of getting used to.
Since Monday, I have lost 6 lbs in weight, so that is a good thing.

I understand that all meds come with the inherent risks of side effects. It is up to each individual to weigh up the risks v benefits and do enough research to satisfy ourselves.
So for me weight gain was a deal breaker, for you it may be not so important.
So my advice is do some research of your own so that when you next visit your Gp or nurse you will feel a bit more in control.
Good luck with whatever path you choose.
 
I'm currently on sitagliptin with no problems but previously I was taking pioglitazone or actos and found that I was increasingly hungry and ended up putting on 10 lbs in a relatively short period of time but on the plus side it did control my blood sugar even on the lowest dose which I was taking.
 
I had sitagliptin added to my script when my hBAc1 went to 66 and my weight was creeping ever upwards after I gav up smoking. I had no side effects that I noticed and it did reduce my levels a little.

However on the basis I was told this would be the last stage before having to take insulin it proved to be the catalyst to me taking control, going on a calorie controlled diet, losing a little over a stone, then going lo carb and six months on the best hBAc1 result I can remember and having a gliclazide taken off my script as a result.

All in all it turned into the best impact for my diabetes and the only positive one for 15 years.


Diagnosed type II 1998 2 x 80 mg Gliclazide, 4 x 500mg Metformin and 1 x 100mg Sitagliptin - HbA1c - 48 mmol/mol
 
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