What is 'Januvia' all about

My Doctor just switched my Type 2
diabetes med from Metformin to
a new med called Januvia. My
question is what's the scoop on
Januvia ??

Jim
T2

JCarew wrote:
> My Doctor just switched my Type 2
> diabetes med from Metformin to
> a new med called Januvia. My
> question is what's the scoop on
> Januvia ??
>
> Jim
> T2
>

There are four phases to insulin release. The first one is cephalic, so
called because it's a learned response created in the brain. It's the
same learned response as salivating when you smell something good. (And
everyone always thought walking by a bakery made you gain weight, when
it really causes a small insulin release.)

The second type is caused by the physical filling of the stomach, which
releases gastric incretin hormones, like GLP-1. This is the same stuff
as Byetta. The problem is that it has a short half-life and there is a
chemical cascade that uses it up quickly. Januvia is essentially a GLP-1
reductase inhibitor. It tries to make it last longer.

We have all talked many times about Phase-1 and Phase-2 insulin
response, which are triggered by the glucose increase caused by food,
and when Phase-1 isn't enough, respectively.

Jim

On May 18, 11:39?pm, "JCarew" <oth...@prodigy.net> wrote:
> My Doctor just switched my Type 2
> diabetes med from Metformin to
> a new med called Januvia. My
> question is what's the scoop on
> Januvia ??
>
> Jim
> T2

http://www.januvia.com/sitagliptin_p.../faq/index.jsp

(excerpt)

JANUVIA is a once-daily pill that, along with diet and exercise, helps
lower blood sugar levels in people with type 2 diabetes. It's a type
of prescription diabetes medicine called a DPP-4 inhibitor (blocker).
DPP-4 blockers enhance the body's own ability to keep blood sugar
levels balanced. A doctor may prescribe JANUVIA alone or together with
certain other diabetes medicines to help control blood sugar.

I've been on Januvia since May 2nd. I was previously taking Actoplusmet
which combined Actos and Metformin, as well as Amaryl. All worked well for
keeping good control but had problems with weight gain and fluid retention
and lows when didn't eat often enough. Now I take the Januvia 100 mg once a
day and Metformin 500 2x's day and have the same good control but no weight
gain, no swelling, no episodes of hypoglycemia. I have lost 6 pounds without
any change in diet so I know it had to be fluid. I'm trying to motivate
myself to eat a healthier diet and exercise so maybe I can lose the other 20
pounds I gained while on Actos. I've had no side affects although some
people report nasal congestion. Maybe some constipation problems but that's
easily fixable. I'm pleased with the Januvia. I haven't seen many people
saying they are taking it. It's fairly new- since October/06.
"JCarew" <othmer@prodigy.net> wrote in message
news:8Yw3i.3208$y_7.1081@newssvr27.news.prodigy.ne t...
>
> My Doctor just switched my Type 2
> diabetes med from Metformin to
> a new med called Januvia. My
> question is what's the scoop on
> Januvia ??
>
> Jim
> T2
>
>
>
>

JCarew wrote:
> My Doctor just switched my Type 2
> diabetes med from Metformin to
> a new med called Januvia. My
> question is what's the scoop on
> Januvia ??
>
> Jim
> T2

Januvia is a DPP-4 inhibitor. What that means is that it partially
prevents the enzyme DPP-4 from breaking down GLP-1, GLP-2,; and GIP (gut
hormones) from changing as rapidly from an active to an inactive state.
Since it allows the GLP-1 produced in your own body to remain active
longer, it can increase insulin secretion from the beta-cells, decrease
glucagon secretion from the alpha-cells. Insulin suppresses glucagon so
as to the reduce the abnormal amounts of glucose produced by the liver.
Byetta is a substitute for GLP-1 that is about 50% similar chemically,
but is not broken down by DPP-4. Januvia has some of the same results as
Byetta but it is not as powerful. Byetta may help to restore first
phase insulin secretion. In animal models Byetta actually has increased
beta-cell mass, but this hasn't been proven in humans.

Januvia was approved for combined use with metformin so your doctor did
not have to remove metformin from your therapy.

Like most meds used for reducing A1c and glucose, Januvia does the most
for BG control in patients with higher A1c levels. I used Januvia for 4
months and it had little effect on my BG numbers.

Frank

On 2007-05-19 00:20:41 -0700, Kurt <kurtwheeling1965@hotmail.com> said:

> On May 18, 11:39?pm, "JCarew" <oth...@prodigy.net> wrote:
>> My Doctor just switched my Type 2
>> diabetes med from Metformin to
>> a new med called Januvia. My
>> question is what's the scoop on
>> Januvia ??
>>
>> Jim
>> T2
>
> http://www.januvia.com/sitagliptin_p.../faq/index.jsp
>
> (excerpt)
>
> JANUVIA is a once-daily pill that, along with diet and exercise, helps
> lower blood sugar levels in people with type 2 diabetes. It's a type
> of prescription diabetes medicine called a DPP-4 inhibitor (blocker).
> DPP-4 blockers enhance the body's own ability to keep blood sugar
> levels balanced. A doctor may prescribe JANUVIA alone or together with
> certain other diabetes medicines to help control blood sugar.

I've been on Januvia for several months - Doc took me off Metformin at
the same time....

Glucose control is better than ever and "even" throughout the day -
also got rid of annoying Metformin side effects. I'm a believer...!

Great stuff, but it's expensive.....

PC

"Proconsul" <proconsul@cox.net> wrote in message
news:2007051922180016807-proconsul@coxnet...
> On 2007-05-19 00:20:41 -0700, Kurt <kurtwheeling1965@hotmail.com> said:
>
> > On May 18, 11:39?pm, "JCarew" <oth...@prodigy.net> wrote:
> >> My Doctor just switched my Type 2
> >> diabetes med from Metformin to
> >> a new med called Januvia. My
> >> question is what's the scoop on
> >> Januvia ??
> >>
> >> Jim
> >> T2
> >
> >
http://www.januvia.com/sitagliptin_p.../faq/index.jsp

..>snip<
>
> I've been on Januvia for several months - Doc took me off Metformin at
> the same time....

Mine did the same
>
> Glucose control is better than ever and "even" throughout the day -
> also got rid of annoying Metformin side effects. I'm a believer...!

Thanks for your reply. Do they have a generic brand ??

Jim

On 2007-05-20 08:42:00 -0700, "JCarew" <othmer@prodigy.net> said:

>
> "Proconsul" <proconsul@cox.net> wrote in message
> news:2007051922180016807-proconsul@coxnet...
>> On 2007-05-19 00:20:41 -0700, Kurt <kurtwheeling1965@hotmail.com> said:
>>
>>> On May 18, 11:39?pm, "JCarew" <oth...@prodigy.net> wrote:
>>>> My Doctor just switched my Type 2
>>>> diabetes med from Metformin to
>>>> a new med called Januvia. My
>>>> question is what's the scoop on
>>>> Januvia ??
>>>>
>>>> Jim
>>>> T2
>>>
>>>
> http://www.januvia.com/sitagliptin_p.../faq/index.jsp
>
> .>snip<
>>
>> I've been on Januvia for several months - Doc took me off Metformin at
>> the same time....
>
> Mine did the same
>>
>> Glucose control is better than ever and "even" throughout the day -
>> also got rid of annoying Metformin side effects. I'm a believer...!
>
> Thanks for your reply. Do they have a generic brand ??

Not for another sixteen or so years......

PC

On Sat, 19 May 2007 19:26:31 -0400, Jefferson
<fwroy@adelphia.netxeopheno> wrote:

>JCarew wrote:
>> My Doctor just switched my Type 2
>> diabetes med from Metformin to
>> a new med called Januvia. My
>> question is what's the scoop on
>> Januvia ??
>>
>> Jim
>> T2
>
>Januvia is a DPP-4 inhibitor. What that means is that it partially
>prevents the enzyme DPP-4 from breaking down GLP-1, GLP-2,; and GIP (gut
>hormones) from changing as rapidly from an active to an inactive state.
>Since it allows the GLP-1 produced in your own body to remain active
>longer, it can increase insulin secretion from the beta-cells, decrease
>glucagon secretion from the alpha-cells. Insulin suppresses glucagon so
>as to the reduce the abnormal amounts of glucose produced by the liver.
> Byetta is a substitute for GLP-1 that is about 50% similar chemically,
>but is not broken down by DPP-4. Januvia has some of the same results as
>Byetta but it is not as powerful. Byetta may help to restore first
>phase insulin secretion. In animal models Byetta actually has increased
>beta-cell mass, but this hasn't been proven in humans.
>
>Januvia was approved for combined use with metformin so your doctor did
>not have to remove metformin from your therapy.
>
>Like most meds used for reducing A1c and glucose, Januvia does the most
>for BG control in patients with higher A1c levels. I used Januvia for 4
>months and it had little effect on my BG numbers.
>
>Frank

Thanks Frank. Not the OP but interested in the thread.

A question for any of you guys who use Januvia, What was your A1c just
before starting Januvia?

Thanks,

RB

On Sat, 19 May 2007 06:39:00 GMT, "JCarew" <othmer@prodigy.net> wrote:

>
> My Doctor just switched my Type 2
> diabetes med from Metformin to
> a new med called Januvia. My
> question is what's the scoop on
> Januvia ??
>

Here's good reference:

http://www.webmd.com/drugs/drug-1457...e=JANUVIA+Oral

(caution, I use text email client and the above URL may get folded on
2 lines)



======= Tecknomage =======
San Diego, CA
The Mage Soapbox
http://magesoapbox.blogspot.com/

A1c was 6.5 in March. Still on Actoplusmet and Amaryl until May 2nd. Have a
return appointment on June 1st and will do new A1c then to see what happens.


"RB" <RB@hotmail.com> wrote in message
news:nc1253lq42na1ecdqrnk9ahecuqptlosbu@4ax.com...
> On Sat, 19 May 2007 19:26:31 -0400, Jefferson
> <fwroy@adelphia.netxeopheno> wrote:
>
>>JCarew wrote:
>>> My Doctor just switched my Type 2
>>> diabetes med from Metformin to
>>> a new med called Januvia. My
>>> question is what's the scoop on
>>> Januvia ??
>>>
>>> Jim
>>> T2
>>
>>Januvia is a DPP-4 inhibitor. What that means is that it partially
>>prevents the enzyme DPP-4 from breaking down GLP-1, GLP-2,; and GIP (gut
>>hormones) from changing as rapidly from an active to an inactive state.
>>Since it allows the GLP-1 produced in your own body to remain active
>>longer, it can increase insulin secretion from the beta-cells, decrease
>>glucagon secretion from the alpha-cells. Insulin suppresses glucagon so
>>as to the reduce the abnormal amounts of glucose produced by the liver.
>> Byetta is a substitute for GLP-1 that is about 50% similar chemically,
>>but is not broken down by DPP-4. Januvia has some of the same results as
>>Byetta but it is not as powerful. Byetta may help to restore first
>>phase insulin secretion. In animal models Byetta actually has increased
>>beta-cell mass, but this hasn't been proven in humans.
>>
>>Januvia was approved for combined use with metformin so your doctor did
>>not have to remove metformin from your therapy.
>>
>>Like most meds used for reducing A1c and glucose, Januvia does the most
>>for BG control in patients with higher A1c levels. I used Januvia for 4
>>months and it had little effect on my BG numbers.
>>
>>Frank
>
> Thanks Frank. Not the OP but interested in the thread.
>
> A question for any of you guys who use Januvia, What was your A1c just
> before starting Januvia?
>
> Thanks,
>
> RB

RB wrote:

> Thanks Frank. Not the OP but interested in the thread.

There is a blog on Januvia that has over 1,200 posts -
http://diabetes.blog.com/1162417/?page=13#cmts.
>
> A question for any of you guys who use Januvia, What was your A1c just
> before starting Januvia?

My A1c was 5.8%, but I was using low dose regular and NPH insulin in the
evening. Since I discontinued Januvia, I started 2 units regular and 4
units NPH, most of the time before eating breakfast and sometimes
afterwards. The regular covers breakfast carbs and suppresses glucagon.
The NPH covers lunch and pre-dinner. Before dinner I inject 3 units
regular and test BG between 8:30 PM and bedtime. Depending on the BG
reading I usually inject 6 units NPH, but it varies between 4 & 7 units.
If the BG is higher than what I want I may also add some regular. The
results are fairly predictable, but infrequently over 100 or under 70
FBG. This usually gives me a FBG in the low 80 mg/dl. The carbs in my
breakfast and lunch are fairly standard, but they vary the most for dinner.

My weight has only changed a few pounds in the last several years and my
body fat is 17-18%.

My objective is to have a good FBG as well as good postprandial BGs
during the day.

My next A1c should be less than 5.8%.

Frank
--------------
metformin 500x2/day.
GLOSSARY OF BIOCHEMICAL, MEDICAL CHEMISTRY, CELL BIOLOGY, AND DIABETIC
TERMS - http://home.comcast.net/~fwroy/glossary.html (Always under
construction)

On Mon, 21 May 2007 06:57:33 -0500, "Janice" <jrupton@suddenlink.net>
wrote:

>A1c was 6.5 in March. Still on Actoplusmet and Amaryl until May 2nd. Have a
>return appointment on June 1st and will do new A1c then to see what happens.
>
>
>"RB" <RB@hotmail.com> wrote in message
>news:nc1253lq42na1ecdqrnk9ahecuqptlosbu@4ax.com.. .
>> On Sat, 19 May 2007 19:26:31 -0400, Jefferson
>> <fwroy@adelphia.netxeopheno> wrote:
>>
>>>JCarew wrote:
>>>> My Doctor just switched my Type 2
>>>> diabetes med from Metformin to
>>>> a new med called Januvia. My
>>>> question is what's the scoop on
>>>> Januvia ??
>
>>
>> A question for any of you guys who use Januvia, What was your A1c just
>> before starting Januvia?
>>
>> Thanks,
>>
>> RB
>

Thanks for the info.

With the news about Avandia I think I will discuss with my doc a
possible change to Januvia and drop the Avandia and Starlix I now
take. That would have me taking a 1000mg of metformin daily and the
Januvia if he agrees.

I checked the formulary of my mail-order pharmacy and Januvia is
already listed. My out of pocket cost would actually go down.

Of course we may hear about dangers of Januvia in future news spots.

RB

Jim, I dont know anything about Januvia, but I bet there is a lot to be
found on either webmd or google.

I wouldnt take any new pill until iu knew all about it including their
side effects.

Loretta

>> On Sun, 20 May 2007 22:38:12 -0400, RB wrote
(in article <nc1253lq42na1ecdqrnk9ahecuqptlosbu@4ax.com>):
>
> A question for any of you guys who use Januvia, What was your A1c just
> before starting Januvia? <<

Hi, all. I'm a type 2, diagnosed five and a half years ago, started on
metformin and glucotrol but they quickly took me off the glucotrol as my
numbers were so good. For most of five years, I had A1Cs of 5.8 - 6.1. Last
fall, they started to go up. I've been at 7.3 since the beginning of this
year, and my doctor was _going_ to put me on Avandia back in March, but I
didn't like what I was reading about it (which turned out to be pretty lucky,
considering recent news!), so instead he upped my metformin from 1000 mg/day
to 1500 mg/day.

Now, though, even with some weight loss, more careful dieting than usual, and
moderate-to-heavy regular exercise, my A1C is _still_ at 7.3. And this is
after several months of increased metformin. So, now my doctor would like me
to start on Januvia/Janumet. He sent me home to research it first (he knows
I don't take anything without a lot of research first!), and if I'm
comfortable with it, I'll start taking it next week.

So far, I like what I'm hearing about Januvia (which is much better than what
I hear from people about their experiences with Byetta). Here's hoping my
A1Cs come down. I'll be sure to report back about it after a few months.

Amy

On Tue, 05 Jun 2007 15:10:50 GMT, Amy Guskin
<aisling@fjordstone.com> wrote:

>>> On Sun, 20 May 2007 22:38:12 -0400, RB wrote
>(in article <nc1253lq42na1ecdqrnk9ahecuqptlosbu@4ax.com>):
>>
>> A question for any of you guys who use Januvia, What was your A1c just
>> before starting Januvia? <<
>
>Hi, all. I'm a type 2, diagnosed five and a half years ago, started on
>metformin and glucotrol but they quickly took me off the glucotrol as my
>numbers were so good. For most of five years, I had A1Cs of 5.8 - 6.1. Last
>fall, they started to go up. I've been at 7.3 since the beginning of this
>year, and my doctor was _going_ to put me on Avandia back in March, but I
>didn't like what I was reading about it (which turned out to be pretty lucky,
>considering recent news!), so instead he upped my metformin from 1000 mg/day
>to 1500 mg/day.
>
>Now, though, even with some weight loss, more careful dieting than usual, and
>moderate-to-heavy regular exercise, my A1C is _still_ at 7.3. And this is
>after several months of increased metformin. So, now my doctor would like me
>to start on Januvia/Janumet. He sent me home to research it first (he knows
>I don't take anything without a lot of research first!), and if I'm
>comfortable with it, I'll start taking it next week.
>
>So far, I like what I'm hearing about Januvia (which is much better than what
>I hear from people about their experiences with Byetta). Here's hoping my
>A1Cs come down. I'll be sure to report back about it after a few months.
>
>Amy

Has your menu or your lifestyle changed during that period?

What are your post-prandial numbers like, and have they
changed?

Have you read this before:
http://www.alt-support-diabetes.org/NewlyDiagnosed.htm ?


Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/
http://loraltravel.blogspot.com/
latest: Slovenia

>> On Tue, 5 Jun 2007 20:55:13 -0400, Alan S wrote
(in article <bb1c63pkt67hmcq5gl72etajide2rd40sl@4ax.com>):

> On Tue, 05 Jun 2007 15:10:50 GMT, Amy Guskin
> <aisling@fjordstone.com> wrote:
>
>>>> On Sun, 20 May 2007 22:38:12 -0400, RB wrote
>> (in article <nc1253lq42na1ecdqrnk9ahecuqptlosbu@4ax.com>):
>>>
>>> A question for any of you guys who use Januvia, What was your A1c just
>>> before starting Januvia? <<
>>
>> Hi, all. I'm a type 2, diagnosed five and a half years ago, started on
>> metformin and glucotrol but they quickly took me off the glucotrol as my
>> numbers were so good. For most of five years, I had A1Cs of 5.8 - 6.1.
>> Last
>> fall, they started to go up. I've been at 7.3 since the beginning of this
>> year, and my doctor was _going_ to put me on Avandia back in March, but I
>> didn't like what I was reading about it (which turned out to be pretty
>> lucky,
>> considering recent news!), so instead he upped my metformin from 1000
>> mg/day
>> to 1500 mg/day.
>>
>> Now, though, even with some weight loss, more careful dieting than usual,
>> and
>> moderate-to-heavy regular exercise, my A1C is _still_ at 7.3. And this is
>> after several months of increased metformin. So, now my doctor would like
>> me
>> to start on Januvia/Janumet. He sent me home to research it first (he
>> knows
>> I don't take anything without a lot of research first!), and if I'm
>> comfortable with it, I'll start taking it next week.
>>
>> So far, I like what I'm hearing about Januvia (which is much better than
>> what
>> I hear from people about their experiences with Byetta). Here's hoping my
>> A1Cs come down. I'll be sure to report back about it after a few months.
>>
>> Amy
>
> Has your menu or your lifestyle changed during that period? <<

Hi, Alan, and sorry for the delayed reply. If you mean during that five-year
period, yes, my entire _life_ changed. I was diagnosed as the consequence of
an accident in which I dislocated and broke both shoulders, so I spent nearly
two months being cared for in ways most adults can't (and don't want to!)
imagine by my husband, my mother, my mother-in-law, and nurses. I lost 70
pounds in that first five months, and _drastically_ changed my eating.
Instead of eating anything I wanted (and at my weight, I shouldn't have been
doing that, diabetes or no diabetes!), I started to eat properly. I'd always
loved healthy food like vegetables, whole grains, etc., and we'd long
belonged to a local organic co-op farm, but I was also eating whatever sweets
and dessert foods I felt like. No more!

I did well for a few years, but last fall the numbers started to creep up,
and my A1C was 7.3 for my last two tests. As I say, I resisted going on
Avandia, but when my doctor suggested Januvia and I looked into it, it looked
like a reasonable thing to try.

>> What are your post-prandial numbers like, and have they
> changed? <<

I'm just at the end of my second week on Januvia, and yes, I've now seen some
change. Before I started the Januvia (and was just taking 1500/mg of
metformin/day), my dawn effect readings were regularly in the 150s; they're
now regularly in the 130s, and today's was even a startling 127! Before lunch
varies wildly, which is odd since I'm working hard at the gym between
breakfast and lunch four days a week -- but still, those are now between 90s
and the high 120s, instead of spiking as high as 170 on some days. Pre-dinner
went from wildly varying 135-200 to a more reasonable 97-115ish. And, late
evening reading is now almost always between 110 and 135, with the higher
numbers always attributable to eating dinner entirely too late (and too close
to bedtime). Before, they were between 150-200.

I'm hoping to hear of more successes with Januvia, and hopefully they won't
find out anything terrible about it in the next few years of real-world
trials!

>> Have you read this before:
> http://www.alt-support-diabetes.org/NewlyDiagnosed.htm ?<<

Yes, I have -- thanks.

Amy
--
"In my line of work you gotta keep repeating things over and over and over
again for the truth to sink in, to kinda catapult the propaganda." - George
W. Bush, May 24, 2005

*A1c upon diagnosis. 12.6 (March 07)
*2nd A1c Was on Metformin, Actos, then on Metformin, Januvia 6.1 (June 07)
Although the A1c came way down, my BG numbers have been a little higher on
the lower dose of Metformin and Januvia. Only been on Januvia going into my
2nd month. Time will tell how it is working. Most of that lowering in my
A1c was the totally change in my life and diet of what/how I was
eating/exercising. The meds helped, no doubt, but before diagnosed, I ate
what I wanted and was a couch potato.
Kris

In alt.support.diabetes Amy Guskin <aisling@fjordstone.com> wrote:
: >> On Tue, 5 Jun 2007 20:55:13 -0400, Alan S wrote
: (in article <bb1c63pkt67hmcq5gl72etajide2rd40sl@4ax.com>):

: > On Tue, 05 Jun 2007 15:10:50 GMT, Amy Guskin
: > <aisling@fjordstone.com> wrote:
: >
: >>>> On Sun, 20 May 2007 22:38:12 -0400, RB wrote
: >> (in article <nc1253lq42na1ecdqrnk9ahecuqptlosbu@4ax.com>):
: >>>
: >>> A question for any of you guys who use Januvia, What was your A1c just
: >>> before starting Januvia? <<
: >>
: >> Hi, all. I'm a type 2, diagnosed five and a half years ago, started on
: >> metformin and glucotrol but they quickly took me off the glucotrol as my
: >> numbers were so good. For most of five years, I had A1Cs of 5.8 - 6.1.
: >> Last
: >> fall, they started to go up. I've been at 7.3 since the beginning of this
: >> year, and my doctor was _going_ to put me on Avandia back in March, but I
: >> didn't like what I was reading about it (which turned out to be pretty
: >> lucky,
: >> considering recent news!), so instead he upped my metformin from 1000
: >> mg/day
: >> to 1500 mg/day.
: >>
: >> Now, though, even with some weight loss, more careful dieting than usual,
: >> and
: >> moderate-to-heavy regular exercise, my A1C is _still_ at 7.3. And this is
: >> after several months of increased metformin. So, now my doctor would like
: >> me
: >> to start on Januvia/Janumet. He sent me home to research it first (he
: >> knows
: >> I don't take anything without a lot of research first!), and if I'm
: >> comfortable with it, I'll start taking it next week.
: >>
: >> So far, I like what I'm hearing about Januvia (which is much better than
: >> what
: >> I hear from people about their experiences with Byetta). Here's hoping my
: >> A1Cs come down. I'll be sure to report back about it after a few months.
: >>
: >> Amy
: >
: > Has your menu or your lifestyle changed during that period? <<

: Hi, Alan, and sorry for the delayed reply. If you mean during that five-year
: period, yes, my entire _life_ changed. I was diagnosed as the consequence of
: an accident in which I dislocated and broke both shoulders, so I spent nearly
: two months being cared for in ways most adults can't (and don't want to!)
: imagine by my husband, my mother, my mother-in-law, and nurses. I lost 70
: pounds in that first five months, and _drastically_ changed my eating.
: Instead of eating anything I wanted (and at my weight, I shouldn't have been
: doing that, diabetes or no diabetes!), I started to eat properly. I'd always
: loved healthy food like vegetables, whole grains, etc., and we'd long
: belonged to a local organic co-op farm, but I was also eating whatever sweets
: and dessert foods I felt like. No more!

: I did well for a few years, but last fall the numbers started to creep up,
: and my A1C was 7.3 for my last two tests. As I say, I resisted going on
: Avandia, but when my doctor suggested Januvia and I looked into it, it looked
: like a reasonable thing to try.

: >> What are your post-prandial numbers like, and have they
: > changed? <<

: I'm just at the end of my second week on Januvia, and yes, I've now seen some
: change. Before I started the Januvia (and was just taking 1500/mg of
: metformin/day), my dawn effect readings were regularly in the 150s; they're
: now regularly in the 130s, and today's was even a startling 127! Before lunch
: varies wildly, which is odd since I'm working hard at the gym between
: breakfast and lunch four days a week -- but still, those are now between 90s
: and the high 120s, instead of spiking as high as 170 on some days. Pre-dinner
: went from wildly varying 135-200 to a more reasonable 97-115ish. And, late
: evening reading is now almost always between 110 and 135, with the higher
: numbers always attributable to eating dinner entirely too late (and too close
: to bedtime). Before, they were between 150-200.

: I'm hoping to hear of more successes with Januvia, and hopefully they won't
: find out anything terrible about it in the next few years of real-world
: trials!

: >> Have you read this before:
: > http://www.alt-support-diabetes.org/NewlyDiagnosed.htm ?<<

: Yes, I have -- thanks.

: Amy

Amy,
What do ou eat at your meals? How much "wholesome" whole grains? how
amny carbs at a meal, etc. If you coul dgive us some samples of your
typical breakfast, lunch and dinner, some of us might spot some things
that changing a bit could help.

Glad to hear you numbers are goin gdown, but they are s\till a bi thigh
and, perhaps some food changes could help you along. Some of us can
tolerater whole grains and some of us find we have to limit them severly
to keep good bgs. Your testing may help you find out how you actually
react to this kind of food.

Wendy

On Sat, 23 Jun 2007 14:59:21 GMT, Amy Guskin
<aisling@fjordstone.com> wrote:
(read, but snipped for brevity>
>my dawn effect readings were regularly in the 150s; they're
>now regularly in the 130s, and today's was even a startling 127! Before lunch
>varies wildly, which is odd since I'm working hard at the gym between
>breakfast and lunch four days a week -- but still, those are now between 90s
>and the high 120s, instead of spiking as high as 170 on some days. Pre-dinner
>went from wildly varying 135-200 to a more reasonable 97-115ish. And, late
>evening reading is now almost always between 110 and 135, with the higher
>numbers always attributable to eating dinner entirely too late (and too close
>to bedtime). Before, they were between 150-200.

The numbers missing there are the ones that interest me. All
those are "pre-" numbers.

What are your BG's like an hour after you eat? And what are
you eating? read this, and you'll see why I ask:
http://www.alt-support-diabetes.org/NewlyDiagnosed.htm



Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraltraveloz.blogspot.com/
latest: The Tropical North
http://loraltravel.blogspot.com/
latest: Slovenia
http://loraldiabetes.blogspot.com/
latest: Jennifer's Story

>> On Sat, 23 Jun 2007 14:48:30 -0400, W. Baker wrote
(in article <f5jptu$ich$1@reader2.panix.com>):

> In alt.support.diabetes Amy Guskin <aisling@fjordstone.com> wrote:
>>>> On Tue, 5 Jun 2007 20:55:13 -0400, Alan S wrote
>> (in article <bb1c63pkt67hmcq5gl72etajide2rd40sl@4ax.com>):
>
>>> On Tue, 05 Jun 2007 15:10:50 GMT, Amy Guskin
>>> <aisling@fjordstone.com> wrote:
>>>
>>>>>> On Sun, 20 May 2007 22:38:12 -0400, RB wrote
>>>> (in article <nc1253lq42na1ecdqrnk9ahecuqptlosbu@4ax.com>):
>>>>>
>>>>> A question for any of you guys who use Januvia, What was your A1c just
>>>>> before starting Januvia? <<
>>>>
>>>> Hi, all. I'm a type 2, diagnosed five and a half years ago, started on
>>>> metformin and glucotrol but they quickly took me off the glucotrol as my
>>>> numbers were so good. For most of five years, I had A1Cs of 5.8 - 6.1.
>>>> Last
>>>> fall, they started to go up. I've been at 7.3 since the beginning of
>>>> this
>>>> year, and my doctor was _going_ to put me on Avandia back in March, but I
>>>> didn't like what I was reading about it (which turned out to be pretty
>>>> lucky,
>>>> considering recent news!), so instead he upped my metformin from 1000
>>>> mg/day
>>>> to 1500 mg/day.
>>>>
>>>> Now, though, even with some weight loss, more careful dieting than usual,
>>>> and
>>>> moderate-to-heavy regular exercise, my A1C is _still_ at 7.3. And this
>>>> is
>>>> after several months of increased metformin. So, now my doctor would
>>>> like
>>>> me
>>>> to start on Januvia/Janumet. He sent me home to research it first (he
>>>> knows
>>>> I don't take anything without a lot of research first!), and if I'm
>>>> comfortable with it, I'll start taking it next week.
>>>>
>>>> So far, I like what I'm hearing about Januvia (which is much better than
>>>> what
>>>> I hear from people about their experiences with Byetta). Here's hoping
>>>> my
>>>> A1Cs come down. I'll be sure to report back about it after a few months.
>>>>
>>>> Amy
>>>
>>> Has your menu or your lifestyle changed during that period? <<
>
>> Hi, Alan, and sorry for the delayed reply. If you mean during that
>> five-year
>> period, yes, my entire _life_ changed. I was diagnosed as the consequence
>> of
>> an accident in which I dislocated and broke both shoulders, so I spent
>> nearly
>> two months being cared for in ways most adults can't (and don't want to!)
>> imagine by my husband, my mother, my mother-in-law, and nurses. I lost 70
>> pounds in that first five months, and _drastically_ changed my eating.
>> Instead of eating anything I wanted (and at my weight, I shouldn't have
>> been
>> doing that, diabetes or no diabetes!), I started to eat properly. I'd
>> always
>> loved healthy food like vegetables, whole grains, etc., and we'd long
>> belonged to a local organic co-op farm, but I was also eating whatever
>> sweets
>> and dessert foods I felt like. No more!
>
>> I did well for a few years, but last fall the numbers started to creep up,
>> and my A1C was 7.3 for my last two tests. As I say, I resisted going on
>> Avandia, but when my doctor suggested Januvia and I looked into it, it
>> looked
>> like a reasonable thing to try.
>
>>>> What are your post-prandial numbers like, and have they
>>> changed? <<
>
>> I'm just at the end of my second week on Januvia, and yes, I've now seen
>> some
>> change. Before I started the Januvia (and was just taking 1500/mg of
>> metformin/day), my dawn effect readings were regularly in the 150s; they're
>> now regularly in the 130s, and today's was even a startling 127! Before
>> lunch
>> varies wildly, which is odd since I'm working hard at the gym between
>> breakfast and lunch four days a week -- but still, those are now between
>> 90s
>> and the high 120s, instead of spiking as high as 170 on some days.
>> Pre-dinner
>> went from wildly varying 135-200 to a more reasonable 97-115ish. And, late
>> evening reading is now almost always between 110 and 135, with the higher
>> numbers always attributable to eating dinner entirely too late (and too
>> close
>> to bedtime). Before, they were between 150-200.
>
>> I'm hoping to hear of more successes with Januvia, and hopefully they won't
>> find out anything terrible about it in the next few years of real-world
>> trials!
>
>>>> Have you read this before:
>>> http://www.alt-support-diabetes.org/NewlyDiagnosed.htm ?<<
>
>> Yes, I have -- thanks.
>
>> Amy
>
> Amy,
> What do ou eat at your meals? How much "wholesome" whole grains? how
> amny carbs at a meal, etc. If you coul dgive us some samples of your
> typical breakfast, lunch and dinner, some of us might spot some things
> that changing a bit could help. <<

Hi, Wendy. Thanks for the offer of help.

I probably eat better, in general, than most diabetics. We've belonged to a
co-op farm for more than ten years, so for at least two-thirds of the year
I'm eating piles and piles of fresh, organic produce (and buying it from the
supermarket the rest of the year). I love wholesome whole grains, the
grainier the better -- I can't remember the last time we bought white bread
in this house. Truly, I _love_ healthy food, but my problem is that I also
love crappy food (like most of us!)! Because of a busy lifestyle and evil
cravings, I still do pasta and eat bread more than I should. All of my
'sweet goodies' (ice cream, pudding, soda, etc.) are NSA (no sugar added),
but things like pizza and pasta and fluffy rolls to go with chicken franks
or turkey burgers are my downfall, along with large portions. I'm working on
that -- I also need to lose a lot more weight, which will likely also help
with my glucose readings -- by watching my food intake more carefully, and
going to the gym for a hard workout (an hour of cardio) at least 4x/week.
And, getting plenty of exercise on the weekends by doing yardwork/pool
maintenance.

Specifically, breakfast is usually either a South Beach Diet breakfast wrap,
or a bowl of cereal (lately, Glucerna's strawberry and flakes variety).
Lunch varies, but more often than not it's a salad with some deli meat thrown
in for protein and a splash of whatever dressing is around, or a bowl of
cottage cheese. Dinner is usually based around whatever produce we have from
the farm, plus a protein of some kind (no red meat -- we only do fish and
poultry), and usually a carb. My husband is slim and not diabetic, and he is
very fond of pasta and brown rice, so it's usually one of them. I used to
eat _huge_ portions of pasta and rice, because I had convinced myself that
the only carbs I really needed to limit were actual sugars that _started_ as
sugars. But the last two A1Cs have made me re-evaluate my eating habits, and
I'm trying to go back to Diabetes 101 again, and really watching my carbs.
So, I'm being very stingy now with the brown rice and the pasta.

Oh, and snacks are either NSA ice cream, pudding, cookies, or a shake
(Glucerna, Zoic, Boost, etc.).

>> Glad to hear you numbers are goin gdown, but they are s\till a bi thigh
> and, perhaps some food changes could help you along. Some of us can
> tolerater whole grains and some of us find we have to limit them severly
> to keep good bgs. Your testing may help you find out how you actually
> react to this kind of food. <<

Thanks. I'm still seeing a steady downward trend with the Januvia, so I'm
hoping that the change in eating habits plus the change in meds will be all
that I need to do for now, and maybe after twenty or thirty more pounds come
off, I can drop some of the meds. I've been really fortunate since I was
diagnosed in that my sugars do seem to go up and down with my weight, so I'm
hoping that will continue to hold true.

Amy
--
"In my line of work you gotta keep repeating things over and over and over
again for the truth to sink in, to kinda catapult the propaganda." - George
W. Bush, May 24, 2005

>> On Sat, 23 Jun 2007 19:56:04 -0400, Alan S wrote
(in article <cjcr73ptj9235rtcahamlmmbaeevaj9bvr@4ax.com>):

> On Sat, 23 Jun 2007 14:59:21 GMT, Amy Guskin
> <aisling@fjordstone.com> wrote:
> (read, but snipped for brevity>
>> my dawn effect readings were regularly in the 150s; they're
>> now regularly in the 130s, and today's was even a startling 127! Before
>> lunch
>> varies wildly, which is odd since I'm working hard at the gym between
>> breakfast and lunch four days a week -- but still, those are now between
>> 90s
>> and the high 120s, instead of spiking as high as 170 on some days.
>> Pre-dinner
>> went from wildly varying 135-200 to a more reasonable 97-115ish. And, late
>> evening reading is now almost always between 110 and 135, with the higher
>> numbers always attributable to eating dinner entirely too late (and too
>> close
>> to bedtime). Before, they were between 150-200.
>
> The numbers missing there are the ones that interest me. All
> those are "pre-" numbers.
>
> What are your BG's like an hour after you eat? And what are
> you eating? read this, and you'll see why I ask:
> http://www.alt-support-diabetes.org/NewlyDiagnosed.htm <<

Well, of course those are the numbers I'm not testing for. :-) I'm curious
about this:

>>Recent studies have indicated that the most important numbers are your "after
meal" numbers. They may be the most indicative of future complications,
especially heart problems.<<

Do you know offhand what recent studies she's referring to, and how recent
they are? I'd love to look into this further on my own before I make myself
nuts about my one-hour post prandials.

Amy
--
"In my line of work you gotta keep repeating things over and over and over
again for the truth to sink in, to kinda catapult the propaganda." - George
W. Bush, May 24, 2005

In alt.support.diabetes Amy Guskin <aisling@fjordstone.com> wrote:
: >
: > Amy,
: > What do ou eat at your meals? How much "wholesome" whole grains? how
: > amny carbs at a meal, etc. If you coul dgive us some samples of your
: > typical breakfast, lunch and dinner, some of us might spot some things
: > that changing a bit could help. <<

: Hi, Wendy. Thanks for the offer of help.

: I probably eat better, in general, than most diabetics. We've belonged to a
: co-op farm for more than ten years, so for at least two-thirds of the year
: I'm eating piles and piles of fresh, organic produce (and buying it from the
: supermarket the rest of the year). I love wholesome whole grains, the
: grainier the better -- I can't remember the last time we bought white bread
: in this house. Truly, I _love_ healthy food, but my problem is that I also
: love crappy food (like most of us!)! Because of a busy lifestyle and evil
: cravings, I still do pasta and eat bread more than I should. All of my
: 'sweet goodies' (ice cream, pudding, soda, etc.) are NSA (no sugar added),
: but things like pizza and pasta and fluffy rolls to go with chicken franks
: or turkey burgers are my downfall, along with large portions. I'm working on
: that -- I also need to lose a lot more weight, which will likely also help
: with my glucose readings -- by watching my food intake more carefully, and
: going to the gym for a hard workout (an hour of cardio) at least 4x/week.
: And, getting plenty of exercise on the weekends by doing yardwork/pool
: maintenance.

: Specifically, breakfast is usually either a South Beach Diet breakfast wrap,
: or a bowl of cereal (lately, Glucerna's strawberry and flakes variety).
: Lunch varies, but more often than not it's a salad with some deli meat thrown
: in for protein and a splash of whatever dressing is around, or a bowl of
: cottage cheese. Dinner is usually based around whatever produce we have from
: the farm, plus a protein of some kind (no red meat -- we only do fish and
: poultry), and usually a carb. My husband is slim and not diabetic, and he is
: very fond of pasta and brown rice, so it's usually one of them. I used to
: eat _huge_ portions of pasta and rice, because I had convinced myself that
: the only carbs I really needed to limit were actual sugars that _started_ as
: sugars. But the last two A1Cs have made me re-evaluate my eating habits, and
: I'm trying to go back to Diabetes 101 again, and really watching my carbs.
: So, I'm being very stingy now with the brown rice and the pasta.

: Oh, and snacks are either NSA ice cream, pudding, cookies, or a shake
: (Glucerna, Zoic, Boost, etc.).

: >> Glad to hear you numbers are goin gdown, but they are s\till a bi thigh
: > and, perhaps some food changes could help you along. Some of us can
: > tolerater whole grains and some of us find we have to limit them severly
: > to keep good bgs. Your testing may help you find out how you actually
: > react to this kind of food. <<

: Thanks. I'm still seeing a steady downward trend with the Januvia, so I'm
: hoping that the change in eating habits plus the change in meds will be all
: that I need to do for now, and maybe after twenty or thirty more pounds come
: off, I can drop some of the meds. I've been really fortunate since I was
: diagnosed in that my sugars do seem to go up and down with my weight, so I'm
: hoping that will continue to hold true.

: Amy

I snipped alot because this is getting ungainly in length.

I wonder at your breakfast a many of us find, by testing at 1 and 2 hours
after the meal, that we cannot tolerate many carbs in the morning.
Cereal, even "healthy" ones often are too much fo rus to handle. I assume
you do not have any juice at breakfast while your husband is able to drink
a nice big glassful:-) Try moving your cottage cheese to brekfast instead
of the cereal and add a few berries or small amounts of your favorite
food(except banana), like 1/5 of a mango, a half a peach, 5 cherries, 1
apricot, half a clemintine orange, 1/4 of a grapefruit. You get the
picture and top it with some low fat, plain yogurt. See if that works.
It does for me. Others eat egg or dinner type foods like chicken or meal
for breakfast. I have fake eggs once or twice a week with 2 Wasa whole
grin rye crackers (6 grams net of fiber each) adn that also works for me.
I found this out by testing a after the meals at 1 and 2 hours.

Make sure you test yourself after eating those pasta or brown rice dishes
you have at night. Some can tolerate them and some not. I don't
generally eat a starch at dinner as I like to have soem fruit, like a
piece of canteloups, half a rapefruit, etc for dessert. You coul dhave
the starch (about 1/3 C brown rice or 1/2 C pasta) without having the
fruit. Test and see what happens.

Much of the advic e on "healthy eating" doesn't work for many diabetics
and we spike on those lovely whole grains. You have to see how it works
for you. You may well find that you can add some of this kind of food
back into your diet once you get the weight down. Your meter will tell
you when you can.

Moving your body in walking of fancier exercise is a great help too and
can often let you eat more carbs. Once again , your meter will tell you.

I am stoppiong now, as my machine is gettign cranky and I don't want to
loose what I have written.

Wendy

>> On Sat, 23 Jun 2007 19:56:04 -0400, Alan S wrote
(in article <cjcr73ptj9235rtcahamlmmbaeevaj9bvr@4ax.com>):
>
> The numbers missing there are the ones that interest me. All
> those are "pre-" numbers.
>
> What are your BG's like an hour after you eat? And what are
> you eating? read this, and you'll see why I ask:
> http://www.alt-support-diabetes.org/NewlyDiagnosed.htm<<

Okay, for the heck of it, I tried this tonight after dinner. I had a
chili/lime chicken burger (thanks, Trader Joe's) on a whole wheat bun (18g
carb/serving, which is one bun), with ketchup (Heinz, as I was out of the no
sugar stuff), onion, tomato, and avocado, plus Diet Sprite. My husband --
who is slim, and not diabetic -- had two burgers and two buns, and some
sweetened iced tea. An hour and fifteen minutes after eating, my blood sugar
tested at 105, and his tested at 97. Oh, I should add: I take my Januvia
right before dinner, and had a small amount of physical activity after dinner
(vacuuming the pool, which is mainly standing in one place and pushing a
pole).

I have to confess, I was surprised to find it that low that soon after
eating.

Amy
--
"In my line of work you gotta keep repeating things over and over and over
again for the truth to sink in, to kinda catapult the propaganda." - George
W. Bush, May 24, 2005

On Sun, 24 Jun 2007 19:40:07 GMT, Amy Guskin
<aisling@fjordstone.com> wrote:

>Do you know offhand what recent studies she's referring to, and how recent
>they are? I'd love to look into this further on my own before I make myself
>nuts about my one-hour post prandials.
>
>Amy

I can't speak for Jennifer, but you could start here (Jenny
is a different lady):
http://www.phlaunt.com/diabetes/14045678.php

Also, see what develops in the thread I just started on
spikes, and read Gretchen Becker's blog entry on BG
variations here:
http://www.healthcentral.com/diabete...atter/?ic=4033

I would not think that knowing the true numbers should send
you nuts. It's just information that you are missing when
assessing your menu. I've never been one to agree with the
"Ostrich" method of management for any problem.

I've also expanded on Jennifer's advice here:
http://loraldiabetes.blogspot.com/20...ew-adjust.html


Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraltraveloz.blogspot.com/
latest: Up to Kuranda by train
http://loraltravel.blogspot.com/
latest: Slovenia
http://loraldiabetes.blogspot.com/
latest: Jennifer's Story

On Sun, 24 Jun 2007 19:35:00 GMT, Amy Guskin
<aisling@fjordstone.com> wrote:

>All of my
>'sweet goodies' (ice cream, pudding, soda, etc.) are NSA (no sugar added),
>but things like pizza and pasta and fluffy rolls to go with chicken franks
>or turkey burgers are my downfall, along with large portions.

It's not the sugar - it's the carb count. Sugar is only a
part of that, often a minor part.


Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraltraveloz.blogspot.com/
latest: Up to Kuranda by train
http://loraltravel.blogspot.com/
latest: Slovenia
http://loraldiabetes.blogspot.com/
latest: Jennifer's Story