General Information

How to treat type 2 diabetes? Treatment course implies not only pills, but also a change in the entire way of life. Diabetes mellitus type 2 is a condition when receptors don’t accept insulin.

To put it simple insulin fits the receptor, which is on the surface of every cell of our entire body, as the key fits the lock. For certain reasons, this receptor-lock is broken, and the insulin key cannot open it, but it is really necessary to let glucose enter the cells, as it is the main fuel of our body.

However, since insulin does not do its job, meaning it does not deliver glucose to the cells, the glucose also accumulates in the blood, and this is an additional stimulus for the pancreas to start producing even more insulin.

Insulin resistance

Typically, insulin resistance is most common in people who are overweight, but studies show that in 25% of cases it can also occur in people with normal body weight. This is a fact that not only obesity affects insulin sensitivity.

In addition to obesity, there are following causes for the insulin resistance development:

• smoking
• taking certain medications (glucocorticoids, thiazide diuretics, beta-blockers for the cure of hypertension and heartbeat)
• low physical activity
• genetic defects of the receptor
• obesity plays a leading role in the development of insulin resistance

After gaining 35-40% of the standard weight the insulin sensitivity decreases by 40%. This fact is proved by numerous studies.

To treat this disease, there are many popuar methods, including diet, sport exercises, getting rid of smoking as well as a therapy course.

You can treat diabetes mellitus type 2 with both blood glucose lowering drugs and insulin. There are many antidiabetic drugs against of type 2 diabetes today. One of them is Janumet XR.

Due to effect of Metformin and Sitagliptin, which are two key elements of the remedy, the hypoglycemic action of this pharmaceutical product is enchasing substantially. They complement each other, reducing the blood sugar level.

Sitagliptin is a DPP-4 inhibitor, activating incretins, which, in turn regulate glucose homeostasis. When there is a need help to improve the insulin secretion. This suppresses the release of glucagon and, as a consequence, the synthesis of glucose in the liver.

Metformin is biguanide, which increases tolerance to glucose, and then reduces its concentration in the blood and synthesis in the liver.

Precautions

Under certain conditions it is needed to be extremely careful when treating with Janumet (Metformin).

Acute pancreatitis. The physician has to warn the individual: in the presence of pain in the abdominal region or right upper quadrant, it is necessary to terminate the drug usage.

Lactat acid acidosis. It is a heavy and rather frequent condition leading to dangerously fatal consequences. In case of manifestations expression, you must interrupt therapy regimen. You will see it as respiratory embarrassment, epigastric pain, chills, dysemia, muscle spasms, asthenia, gastrointestinal tract disorders.

Renal pathologies. The lactat acid acidosis develops the risk to increase renal disorder that is why it is so vital to monitor the creatinine ratio. Especially it concerns diabetics of mature age, because renal disorders in them can proceed asymptomatically.
In case allergic symptoms manifestation, the medication must be withdrawn.

Surgery. If a diabetic intends for an operation, you should cancel Janumet treatment course two days before and the patient must be put for insulin therapy.

Iodine-containing products. When iodine-containing remedy is taken together with Janumet, it can provoke a renal system problem.

Moreover, there are additional contraindications preventing use of Janumet (Metformin):

• Ketoacidosis
• Kussmaul’s coma
• Infectious diseases
• Shock states
• Diseases provoking hypoxia in tissues
• Liver dysfunction, poisoning, alcohol abuse
• Pregnancy including breastfeeding
• Type I diabetes.
• Age under 18 years

We must mention, that since the main excretion pathway of Sitagliptin and Metformin lies through the renal system, and due to the fact that excretion function of the kidneys reduces with age, the doctor prescribing Janumet (Metformin) must take this aspect into account. The dosage for elderly patients must be carefully adjusted and they have to be under close supervision of treating physician.

What is Metformin?

Generic Janumet (Sitagliptin Metformin) does not affect the ability to manage vehicles or complex mechanisms, but Synagliptin can result in weakness and drowsiness.

Metformin Dose

You can select the Janumet dose schedule basing on individual characteristics, as well as when applying treatment course, effectiveness and tolerance, but you better not exceed the highest daily dose amounting to 100 mg of Sitagliptin.

Adverse reactions:

Digestive tract disorder: at the start of the treatment, there can be such manifestations as abepithymia, diarrhea, sickness, retching, flatus, celialgia (diminishing during food intake); metallic aftertaste in the mouth (3%).

Heart-vascular and blood system (hematopoiesis, blood stasis): in separate events megaloblastic anemia can develop (as a result of vitamin B12 and folic acid malabsorption).

Metabolism: glucopenia; in some cases lacticacidemia can develop (resistant bradyarrhythmia, fragility, hypersomnia, arterial hypotension, respiratory disorders, stomach pain, myodynia, hypothermy).

Reactions which you might experience:

• Skin: eruption, scytitis
• Headaches
• Pancreatitis
• Nausea, abdominal pain
• Anorexia
• Metallic taste in the mouth
• Vomiting
• Diarrhea or constipation
• Dry mouth
• Allergic reactions
• Drowsiness
• Cough
• Anemia
• Lactic acidosis
• Hypoglycemia
• Peripheral edema

Overdose

The lactoacidosis may develop in case of overdose. In this case, it is better to remove the drug remnants from the body, then hemodialysis shall be carried out and the patient’s condition must be under the control.

Symptoms of hypoglycemia are also possible. In case of a light form, doctors reccomend to take a meal rich in carbohydrates.

Interactions

Concomitant diseases require correction of a special treatment strategy. If they are available, it is necessary to combat several pathologies at once, accordingly, there is a need for combining different medications.

There are several drugs, which can change the effectiveness if you use them together. Among them are: Furosemide; Nifedipine; Digoxin; Cyclosporin; Januvia.

Metformin and Alcohol

This product is not compatible with alcohol, since ethanol affects its efficiency.