Type 2 Why I was given junamet

[MTS1980]

Hello good people I was diagnosed more than a month ago and I was put on Metformin 1000Mg daily my blood sugar level cake down from 300 to 200 post parindal and fasting came back to normal like 140 buy my doctor today put on me junamet I was thinking why he changed my medicine I am scared can someone tell me if I will get hypoglycaemia? What are the side effects and us anyone on junamet ? And can sine expert tell me how is it different from vidagliptan the main differences between these two Vidaglipton and sidaglipton thank you all very much

 

[Salvia]

Hello @MTS1980, I can hear from your writing that you seem to be a little bit stressed at the moment, because of your medication being changed, and worrying about hypos. It is undertandable that you might be too stressed during the first consultation to think about querying the reason for the change, but now that you've calmed down a little, perhaps it might be a good idea to contact your gp again to ask why the change. Or possibly the gp nurse/practice nurse (or the equivalent in your country) could explain it and/or help you.

I am not on medication myself, so can't help with your query, but I'm hoping that my reply here will bring up your post higher in the listings, so that someone who may have better information might be able to explain in general terms (only your gp can give you definite reasons).

All the best, and try to relax - perhaps think about it this way: it's not likely that your gp will have given you something that will make your condition worse, but if you do feel ill, then contact gp again.

 

[MTS1980]

Hello @MTS1980, I can hear from your writing that you seem to be a little bit stressed at the moment, because of your medication being changed, and worrying about hypos. It is undertandable that you might be too stressed during the first consultation to think about querying the reason for the change, but now that you've calmed down a little, perhaps it might be a good idea to contact your gp again to ask why the change. Or possibly the gp nurse/practice nurse (or the equivalent in your country) could explain it and/or help you.

I am not on medication myself, so can't help with your query, but I'm hoping that my reply here will bring up your post higher in the listings, so that someone who may have better information might be able to explain in general terms (only your gp can give you definite reasons).

All the best, and try to relax - perhaps think about it this way: it's not likely that your gp will have given you something that will make your condition worse, but if you do feel ill, then contact gp again.

Hello u seem v kind yes indeed i am so tensed and shivering right now because I read on the internet that it can cause pancreatitis thank you so much for helping me so kind best regards

 

[Lamont D]

Hello good people I was diagnosed more than a month ago and I was put on Metformin 1000Mg daily my blood sugar level cake down from 300 to 200 post parindal and fasting came back to normal like 140 buy my doctor today put on me junamet I was thinking why he changed my medicine I am scared can someone tell me if I will get hypoglycaemia? What are the side effects and us anyone on junamet ? And can sine expert tell me how is it different from vidagliptan the main differences between these two Vidaglipton and sidaglipton thank you all very much

Obviously I can't say why your meds were changed but I can try and give you some understanding of maybe the reason.
First of all, did you have digestive problems with metformin? did he try you on slow release form of the drug?
Janumet is a combination of the Gliptin, Januvia (Sitagliptin) and metformin.
The Gliptin decreases the spike from the meals you have ate, so as not to raise your blood sugar too high, this is done to alleviate symptoms of high blood sugar levels.
This also means that before the next meal, your blood sugar levels are in a better position to counter the glucose derived from the meals and increase first insulin response.
So it will also lower your hba1c levels.
The method used to determine whether you have diabetes.
This drug will be used temporarily if you can get your Hba1c levels back or close to normal blood sugar levels.
Or more permanently if you do not have the control necessary to take you off them.
Only time will determine if you get side effects.
The leaflet inside the drug box, will supply you with side issues, but they are very low, for any serious conditions.
I have been on Sitagliptin for four years now and I am very happy on it.
The difference between Sitagliptin and the other Gliptin is how it effects the first insulin response. Your other one may not have made a difference.

Metformin is a very useful drug in the long term and doesn't do much too lower blood sugar levels but it protects your other organs against the imbalance in your blood because of potential high glucose levels, high insulin levels and other hormonal imbalance because of the diabetes.

I hope that helps.

As a final word, the way to get off the meds, is by dietary control as well, reducing your carbs, reducing your plate size, increasing exercise a little (if you can) and being positive about getting your blood sugar levels in good control.

Best wishes

 

[MTS1980]

Obviously I can't say why your meds were changed but I can try and give you some understanding of maybe the reason.
First of all, did you have digestive problems with metformin? did he try you on slow release form of the drug?
Janumet is a combination of the Gliptin, Januvia (Sitagliptin) and metformin.
The Gliptin decreases the spike from the meals you have ate, so as not to raise your blood sugar too high, this is done to alleviate symptoms of high blood sugar levels.
This also means that before the next meal, your blood sugar levels are in a better position to counter the glucose derived from the meals and increase first insulin response.
So it will also lower your hba1c levels.
The method used to determine whether you have diabetes.
This drug will be used temporarily if you can get your Hba1c levels back or close to normal blood sugar levels.
Or more permanently if you do not have the control necessary to take you off them.
Only time will determine if you get side effects.
The leaflet inside the drug box, will supply you with side issues, but they are very low, for any serious conditions.
I have been on Sitagliptin for four years now and I am very happy on it.
The difference between Sitagliptin and the other Gliptin is how it effects the first insulin response. Your other one may not have made a difference.

Metformin is a very useful drug in the long term and doesn't do much too lower blood sugar levels but it protects your other organs against the imbalance in your blood because of potential high glucose levels, high insulin levels and other hormonal imbalance because of the diabetes.

I hope that helps.

As a final word, the way to get off the meds, is by dietary control as well, reducing your carbs, reducing your plate size, increasing exercise a little (if you can) and being positive about getting your blood sugar levels in good control.

Best wishes

U seem very knowledgeable and kind thank for the reply the problem is that I was doing v well on on metformin no side effects and my bg was hovering between 150 to 200 after meals but pls keep in mind that before it was 300 after meals so it's an improvement in my opinion junamet he gave me because he said we need more control IMHO he should have increased my dosage of metformin to 2000 and if it failed then he cud have gone for junamet but my problem is that since I took junket I hd very bad headache and shivering shivering has stopped but not the headache plus sit has very bad side effects see the ucla study in this drug met is safe so I think that but v kind of you to reply

 

[Lamont D]

U seem very knowledgeable and kind thank for the reply the problem is that I was doing v well on on metformin no side effects and my bg was hovering between 150 to 200 after meals but pls keep in mind that before it was 300 after meals so it's an improvement in my opinion junamet he gave me because he said we need more control IMHO he should have increased my dosage of metformin to 2000 and if it failed then he cud have gone for junamet but my problem is that since I took junket I hd very bad headache and shivering shivering has stopped but not the headache plus sit has very bad side effects see the ucla study in this drug met is safe so I think that but v kind of you to reply

200, seems high to me!
The increase in metformin in my opinion would not have made any difference to your readings.
Yes, the side effects you describe are from the Janumet, but what those symptoms show is that it is having an effect, because they seem to be similar to false hypos, which is your blood sugar levels dropping and your body has not adjusted to the new levels you are experiencing.
You should give the drug a bit more time, it should lessen, but if it doesn't, then get in touch with your GP! And discuss it further.
I concur with your GP that you need better blood levels.

Are you doing a low carb diet?
As it will make a difference!

 

[LittleGreyCat]

U seem very knowledgeable and kind thank for the reply the problem is that I was doing v well on on metformin no side effects and my bg was hovering between 150 to 200 after meals but pls keep in mind that before it was 300 after meals so it's an improvement in my opinion junamet he gave me because he said we need more control IMHO he should have increased my dosage of metformin to 2000 and if it failed then he cud have gone for junamet but my problem is that since I took junket I hd very bad headache and shivering shivering has stopped but not the headache plus sit has very bad side effects see the ucla study in this drug met is safe so I think that but v kind of you to reply

https://www.drugs.com/janumet.html

"Janumet may cause a serious condition called lactic acidosis.Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired."

I'm not sure that these match your symptoms but at a minimum you should contact your health team and discuss this with them. I note that the Lactic Acidosis is a side effect of Metformin and you have already been taking Metformin without problems so this doesn't seem that likely. However, talk to your HCPs!

You don't say what your BG is after you started taking the Janumet (Januvia and Metformin) but you need to check that it isn't too low. If Metformin alone was working well then adding a Sitagliptin might be just a bit too effective.

 

[MTS1980]

200, seems high to me!
The increase in metformin in my opinion would not have made any difference to your readings.
Yes, the side effects you describe are from the Janumet, but what those symptoms show is that it is having an effect, because they seem to be similar to false hypos, which is your blood sugar levels dropping and your body has not adjusted to the new levels you are experiencing.
You should give the drug a bit more time, it should lessen, but if it doesn't, then get in touch with your GP! And discuss it further.
I concur with your GP that you need better blood levels.

Are you doing a low carb diet?
As it will make a difference!

200 is high but better than 300 Isn't it?OK here is what I eat whole day my cook is not educated so he cooks this for me in the morning I eat sandwiches brown bread cheese and kabas air fired then in the evening I take sandwiches with egg and cheese and susages with tea no sugar in the night I eat rooti made of wheat with mixed vegetables or chicken curry

 

[MTS1980]

https://www.drugs.com/janumet.html

"Janumet may cause a serious condition called lactic acidosis.Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired."

I'm not sure that these match your symptoms but at a minimum you should contact your health team and discuss this with them. I note that the Lactic Acidosis is a side effect of Metformin and you have already been taking Metformin without problems so this doesn't seem that likely. However, talk to your HCPs!

You don't say what your BG is after you started taking the Janumet (Januvia and Metformin) but you need to check that it isn't too low. If Metformin alone was working well then adding a Sitagliptin might be just a bit too effective.

My bg after taking sidagliptin was 67 then 91 then 128 then 139 choked through whole night right now I have stopped taking junket and my only symptoms is headache pls advise what should I do I ma 37 year old?

 

[Lamont D]

Of course it is,
But it depends on how you test.
Do you test before the meal and two hours after?
This is how we can find out which foods are causing the spikes in your blood sugar levels.
I believe that too much bread and the wheat would be better without them, or reduce the amount you eat!
A good testing regime will help so much with understanding how food affects your blood sugar levels.

 

[MTS1980]

Of course it is,
But it depends on how you test.
Do you test before the meal and two hours after?
This is how we can find out which foods are causing the spikes in your blood sugar levels.
I believe that too much bread and the wheat would be better without them, or reduce the amount you eat!
A good testing regime will help so much with understanding how food affects your blood sugar levels.

Post prandial I test 2 hours after eating my observation is its high after the second meal I take in the day in the evenings that's meals has to be changed u helping me a lot thank u os much h perosnal regards from my side Shafi

 

[MTS1980]

Of course it is,
But it depends on how you test.
Do you test before the meal and two hours after?
This is how we can find out which foods are causing the spikes in your blood sugar levels.
I believe that too much bread and the wheat would be better without them, or reduce the amount you eat!
A good testing regime will help so much with understanding how food affects your blood sugar levels.

Post prandial I test 2 hours after eating my observation is its high after the second meal I take in the day in the evenings that's meals has to be changed u helping me a lot thank u os much h perosnal regards from my side Shafi he just called me the doctor he says reduce the dosage of junamet but don't quit nd I still have e headaches even right now I guess now I ma between the rock an dthe hard place

 

[ringi]

In clinical trials Junamet (Metformin+ sidaglipton) did not increase the number of people who reported hypoglycemia compared to a placebo, therefore as you are taking no other meds, there is a very little risk of hypoglycemia . (Also it does not cause weight gain, unlike some common Type2 drugs.)

This makes Junamet a great combination with “low carb”, and your doctor can reduce the does once you have got your A1C under control with “low carb”.

As to your symptoms, I have no idea if they are the Sidaglipton, Metformin, or just a placebo effect; it takes the skill of a GP to tell this. However, it is possible your symptoms are due to stress.

 

[MTS1980]

In clinical trials Junamet (Metformin+ sidaglipton) did not increase the number of people who reported hypoglycemia compared to a placebo, therefore as you are taking no other meds, there is a very little risk of hypoglycemia . (Also it does not cause weight gain, unlike some common Type2 drugs.)

This makes Junamet a great combination with “low carb”, and your doctor can reduce the does once you have got your A1C under control with “low carb”.

As to your symptoms, I have no idea if they are the Sidaglipton, Metformin, or just a placebo effect; it takes the skill of a GP to tell this. However, it is possible your symptoms are due to stress.

Very kind that u answered but pls do see the ucla study on sidagliptin but yes I am under stress a lot

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[LittleGreyCat]

My bg after taking sidagliptin was 67 then 91 then 128 then 139 choked through whole night right now I have stopped taking junket and my only symptoms is headache pls advise what should I do I ma 37 year old?

Just adding "Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.".

So you may have been experiencing a real or false hypo.

I tend to work in the older units; just done some converting.

https://www.diabetes.co.uk/blood-sugar-converter.html

You say that you were testing at 200 after a meal. This equates to 11.1 which is far too high. Your original 300 equates to 16.7 which is verging on the dangerous. Getting down from 300 to 200 may be an improvement but it isn't good or safe.

67 is 3.7 in "old money" and is definitely a hypo.

91 is 5.1 which is pretty near ideal.

128 is 7.1 which is getting high(ish) but is far better than your previous readings.

139 is up to 7.7 - still high(ish) but in the target area for reasonable control and far, far better than your previous results.

Remember that we are just enthusiasts here, not medical professionals.

However the figures that you have reported indicate that you have been having hypos. This suggests that the Sitagliptin is being a little too effective and you might need a smaller dose.

You haven't given a lot of information; I assume that you are taking the pills at the same time as food so that the increase insulin production has something to work on.

Some idea of useful test times for helpful results:

Immediately on waking (fasting reading)
Immediately before a meal.
One hour after the meal
Two hours after the meal
Immediately before bed. This can be related to your fasting reading to see what your BG is doing over night.

Two messages, then.

1. It looks as though your medical team was quite right to put you on Janumet. The BG readings you have reported to us are far too high even after taking Metformin.
2. You appear to be suffering real (not false) hypos. You need to sort this out. Either your dosage is too high or you are taking the pills at the wrong time. Or both. Talk to your surgery NOW!

 

[MTS1980]

Just adding "Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.".

So you may have been experiencing a real or false hypo.

I tend to work in the older units; just done some converting.

https://www.diabetes.co.uk/blood-sugar-converter.html

You say that you were testing at 200 after a meal. This equates to 11.1 which is far too high. Your original 300 equates to 16.7 which is verging on the dangerous. Getting down from 300 to 200 may be an improvement but it isn't good or safe.

67 is 3.7 in "old money" and is definitely a hypo.

91 is 5.1 which is pretty near ideal.

128 is 7.1 which is getting high(ish) but is far better than your previous readings.

139 is up to 7.7 - still high(ish) but in the target area for reasonable control and far, far better than your previous results.

Remember that we are just enthusiasts here, not medical professionals.

However the figures that you have reported indicate that you have been having hypos. This suggests that the Sitagliptin is being a little too effective and you might need a smaller dose.

You haven't given a lot of information; I assume that you are taking the pills at the same time as food so that the increase insulin production has something to work on.

Some idea of useful test times for helpful results:

Immediately on waking (fasting reading)
Immediately before a meal.
One hour after the meal
Two hours after the meal
Immediately before bed. This can be related to your fasting reading to see what your BG is doing over night.

Two messages, then.

1. It looks as though your medical team was quite right to put you on Janumet. The BG readings you have reported to us are far too high even after taking Metformin.
2. You appear to be suffering real (not false) hypos. You need to sort this out. Either your dosage is too high or you are taking the pills at the wrong time. Or both. Talk to your surgery NOW!

Hello very kind that u replied doc called me and I told him what happend he said take junamet but take half pill this time but I am too scared dunno what to do next I Take tablets with my meals ur correct in assuming this I am under stress because I read sugar makes men impotent but lot of stress my plan is to take metformin 2000 mg nd a 6 km walk every day let's dee what happens so kind

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[LittleGreyCat]

Hello very kind that u replied doc called me and I told him what happend he said take junamet but take half pill this time but I am too scared dunno what to do next I Take tablets with my meals ur correct in assuming this I am under stress because I read sugar makes men impotent but lot of stress my plan is to take metformin 2000 mg nd a 6 km walk every day let's dee what happens so kind

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Deep breath and chill!

Sugar does not make men impotent. Prolonged uncontrolled diabetes can have that effect in some. As can advancing age. Stress and worrying can also have that effect but that generally wears off when you calm down. Assuming that your bits are still working then put that worry on the back burner for now.

Your Doctor's advice to take half a pill sounds very sensible and you should give it serious consideration. There is no reason to be scared. Just check your BG on the usual schedule as suggested in my previous post, and take a bit of glucose if you hit really low numbers.

Your BG was way too high and it may well take your body a while to adjust to running normal or near normal BG levels. This is known as "false hypos" which feel like real hypos. Just go gently and accept this as a period of learning.

I think you are placing too much faith in Metformin. It only lowers your BG by a couple of points. Taking more will not lower your BG more and it may not be sensible to put yourself on the maximum dose immediately. Has your Doctor agreed to this or are you self diagnosing/medicating with the increased dosage due to your fear of Janumet?

I'm sure that you have already been told this, but it takes a while to get used to all the aspects of having diabetes and most people rush around frantically just after diagnosis trying too many things in quick succession and worrying over every little thing.

It took me a long time before I settled down and worked out what was sensible and what was not worth worrying about.

My view; deep breaths, don't panic, it will all settle down soon. Don't be afraid to follow your Doctor's advice.

 

[Lamont D]

Hello very kind that u replied doc called me and I told him what happend he said take junamet but take half pill this time but I am too scared dunno what to do next I Take tablets with my meals ur correct in assuming this I am under stress because I read sugar makes men impotent but lot of stress my plan is to take metformin 2000 mg nd a 6 km walk every day let's dee what happens so kind

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This is my experience.
Taking only metformin will not help with blood sugar levels.
Taking a lower dosage of the Janumet will be more advisable.
Because of what you have told us about what you eat, your blood sugar levels will almost certainly rise and your spikes will be higher because of the initial insulin response, it won't be effective enough.
You have fluctuating blood sugar levels, which is not good. You need good control to ease the symptoms.
Stress will not help!
Speak to your doctor again.
Not taking the drug is your decision, but all the benefits from the drug is your health.
By thinking that the worst will happen does not help.
Exercise is beneficial but using the drug along with a low carb diet will benefit more.

Best wishes

 

[MTS1980]

This is my experience.
Taking only metformin will not help with blood sugar levels.
Taking a lower dosage of the Janumet will be more advisable.
Because of what you have told us about what you eat, your blood sugar levels will almost certainly rise and your spikes will be higher because of the initial insulin response, it won't be effective enough.
You have fluctuating blood sugar levels, which is not good. You need good control to ease the symptoms.
Stress will not help!
Speak to your doctor again.
Not taking the drug is your decision, but all the benefits from the drug is your health.
By thinking that the worst will happen does not help.
Exercise is beneficial but using the drug along with a low carb diet will benefit more.

Best wishes

Thank you again for replying and helping me sir I will definitely read further into junamet but right now my decision is not to take it I am giving it a shot with 2000 mg metformin if it fails then it fails we croas the ridge when we get there doc is right maybe and I am probably wrong but I met someone very wise he isn't a doctor or anything just a sugar patient for40 years according to him doctors always go for the optimum glycemic levels but they come at a cost to our bodies so in the end its all about cost and beniffit analysis right now I want to take chance with a medicine used since 1957 but I am thankful to you for ur time and very precious knowledge and guidance pls accept my most perosnal and warm regards Shafi

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[MTS1980]

Deep breath and chill!

Sugar does not make men impotent. Prolonged uncontrolled diabetes can have that effect in some. As can advancing age. Stress and worrying can also have that effect but that generally wears off when you calm down. Assuming that your bits are still working then put that worry on the back burner for now.

Your Doctor's advice to take half a pill sounds very sensible and you should give it serious consideration. There is no reason to be scared. Just check your BG on the usual schedule as suggested in my previous post, and take a bit of glucose if you hit really low numbers.

Your BG was way too high and it may well take your body a while to adjust to running normal or near normal BG levels. This is known as "false hypos" which feel like real hypos. Just go gently and accept this as a period of learning.

I think you are placing too much faith in Metformin. It only lowers your BG by a couple of points. Taking more will not lower your BG more and it may not be sensible to put yourself on the maximum dose immediately. Has your Doctor agreed to this or are you self diagnosing/medicating with the increased dosage due to your fear of Janumet?

I'm sure that you have already been told this, but it takes a while to get used to all the aspects of having diabetes and most people rush around frantically just after diagnosis trying too many things in quick succession and worrying over every little thing.

It took me a long time before I settled down and worked out what was sensible and what was not worth worrying about.

My view; deep breaths, don't panic, it will all settle down soon. Don't be afraid to follow your Doctor's advice.

No my docotor is against this he says a coordinator to him if I want to increase metformin I hold only go to 1250mg per day he is very adamant that I take half pill of Junamet false hypoglycemia is not something am aware of I ma actually listening to somone who is a sugar patient for 40 years according to him there are only 2 drugs for dibatics no doc will admit that but only 2 on wis insulin second is metformin rest is just a charade he I wrong and so am I but right now I am going to take chance with this if fails then it fails he told me many things which wud be very long to discuss here but fals hypoglycemia is something i will read about thank u so much for taking the time to replying and for u very precious inputs v kind of you most warm n personal regards shafi

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