Type 2 side effects of Sitagliptin, Metformin and Rampipril?

[mikenott]

I have had Type 2 for 17 years. Been through diet, metformin, gliclazide and now on Januvia (sitagliptin) 100mg. Januvia working very well - last two annual checks were 6.1. I also (at my diabetic consultants recommendation) still take Metformin and Gliclazide to "help" the Stitagliptin. Finally, I take 10mg Ramipril. Sometimes I think I rattle when I walk!

Since I retired (now 60), I have been trying to lose weight and get fitter. Part of the driver for this is that every time I go to my GP with anything it's always put down to my diabetes. Sometimes I think if I went in with a broken arm, it would be my diabetes.....

Over the last couple of years I have increasingly felt listless, with a lack of energy, sleepy during the day and my muscles ache constantly making any walking a chore.
Additionally, I have had occasional dizzy spells for 10 to 30 seconds when I stand up of (strangely) when I go into bright light. Never when I am sat down or driving. I have a blood pressure tester and have tested myself and my BP is OK during these dizzy spells (currently 120/70). I have also tested my blood sugars and they are neither high or low.

Having been to the gym every day for six weeks (weight circuits + 30 mins walking up 6% incline) with no improvement in these symptoms. If anything the dizzy spells are getting worse, So, I am starting to look a bit wider and wonder if I have the side effects of Stitagliptin (body aches, muscle aches, lack or loss of strength) and Metformin (muscle pain, sleepiness) and of Ramipril (tiredness/weakness, dizziness, faintness and lightheadedness) - all taken from their "more common side effects" on he web.

I don't want to ask for change unnecessarily and hope that others on this Forum might be able to offer some insights or experience - and I want to approach my GP with an open but informed attitude and hope you will be able to help.

Best wishes

Michael.

 

[douglas99]

Why are you on Ramipril?

 

[Bluetit1802]

The dizziness could well be vertigo. I have recently been diagnosed with this.

 

[mikenott]

Why are you on Ramipril?

Protect kidneys - and it also helps heart.

 

[douglas99]

Protect kidneys - and it also helps heart.

It reduces blood pressure, I believe by affecting the size of your blood vessels. So when you stand up, your blood pressure may drop, as your blood literally stays lower down in the relaxed blood vessels. Sitting down for a blood test isn't the same, as everything is constant again.

As to the Gliclazide and Stitagliptin, I was briefly on Gliclazide, which stimulates insulin production continuously I was told, then moved onto Januvia, which increased production after a trigger, such as eating. So to a layman, it would appear one of the two is redundant.

 

[Lamont D]

I believe the gliptins helps the glicszade keep BSLs near a normal level.

 

[Daibell]

Hi. You don't say whether you are now normal weight? If not, then do reduce the carbs and try to reach a good weight as being overweight can cause so many problems. The three meds you are on and which I was on for a long time don't normally cause noticeable side effects. As Douglas says, Gliclazide stimulates the pancreas to produce more insulin for up to 10 hours and Sitagliptin extends the insulin production time after meals by suppressing the DPP-4 enzyme. I think the two effects use different mechanisms so both together can be worthwhile.

 

[Pilgrim22]

You will most likely be experiencing postural hypotension http://www.medterms.com/script/main/art.asp?articlekey=7671

 

[Bluetit1802]

I still think postural vertigo. Sudden bright light and standing after sitting causing dizziness are classic symptoms.

 

[Lamont D]

Never heard of that. Don't get the bright light but I do get the vertigo. Going to look that up now.

 

[Lamont D]

Yes I have that. Postural or positional vertigo . When I asked my consultant he said that probably surgery can fix but it could be worse than the cure, he said that it is likely to settle down by itself.

 

[Bluetit1802]

Yes I have that. Postural or positional vertigo . When I asked my consultant he said that probably surgery can fix but it could be worse than the cure, he said that it is likely to settle down by itself.

There are some good exercises on YouTube that my GP sent me away to look at. I have been doing them and it seems to be improving, except this afternoon, after having been sat in the car for half an hour or more, got out into bright sunlight and went all light headed. I think it was the sunlight because I only get it posturally from bending down to standing up, not normally from sitting to standing.

I thought it was my BP dropping at first, so I had the 24 hour monitor thing, which proved it wasn't, and I'm not on any meds at all so can't blame that. GP said vertigo.

 

[Lamont D]

There are some good exercises on YouTube that my GP sent me away to look at. I have been doing them and it seems to be improving, except this afternoon, after having been sat in the car for half an hour or more, got out into bright sunlight and went all light headed. I think it was the sunlight because I only get it posturally from bending down to standing up, not normally from sitting to standing.

I thought it was my BP dropping at first, so I had the 24 hour monitor thing, which proved it wasn't, and I'm not on any meds at all so can't blame that. GP said vertigo.

I do a lot of bending over in my job and if I get up quickly! The other is squatting and then getting up. And my meds should not give me vertigo I'm assured.

My GP also said it was low BP. Wrong!

Gonna wait till I see my consultant again!

 

[mikenott]

Looks like orthostatic hypotension could be the reason for the light headedness. Had to dig a bit to find the bright light trigger, but it's there. Will test BP laying down, immediately sitting up and standing to see if it varies. One video gives guidelines of <20 systolic, <10 diastolic and heart rate <15 as being OK. One poster suggested Ramipril may not be helping. Cannot find video on YouTube with exercises to overcome.

Any suggestions on the weakness/lack of strength/tiredness?

Michael.

 

[Lamont D]

I had these symptoms when my BSLs were fluctuating wildly up and down very rapidly. With about another 20 symptoms. I could be talking s.......!