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Sitagliptin, marketed under the brand name "Januvia," is an anti-diabetic medication that can be used alone or in combination with other oral anti-diabetic drugs to control diabetes blood sugar levels.
The advantage of Januvia over other available medications is that it is less likely side effects, especially weight gain and hypoglycemia (low blood sugar levels), making it an attractive alternative. It is considered a second line treatment to be used after primary therapy fails.
Januvia Is A Dipeptidyl Peptidase-4 Inhibitor
Januvia is in a class of medications called Dipeptidyl peptidase-4 (DPP) Inhibitors. To understand how Januvia works, it is first important to understand what happens when food enters the body. When food hits the stomach a class of chemical messengers called Incretins are released. The two main Incretins are glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP). When released, these hormones have three actions: they stimulate release of insulin from the pancreas, they reduce gastric emptying and cause a decrease in food intake, and finally they inhibit the release of glucagon, a hormone that works exactly opposite as insulin.
Januvia Lowers HbA1c Levels
But very quickly after Incretins are released, they are enzymatically broken down by DDP, halting their action. Januvia works by inhibiting the DDP enzyme. This allows Incretins to exist longer in the body and therefore to exert their physiologic actions on the pancreas and liver, leading to better diabetes management. In fact, use of Januvia has been associated with a 0.7% decrease in HbA1c (glycated hemoglobin) levels. HbA1c is one marker used to monitor how well diabetes is controlled.
Januvia Only Appropriate In Type 2 Diabetics
Because Januvia works by increasing insulin production from the pancreas, it is only appropriate for people with type 2 diabetes. Januvia should be avoided in people with type 1 diabetes because it would be ineffective; in Type 1 diabetes the pancreas is incapable of producing insulin.
Rare Fatal Pancreatitis Can Occur With Januvia
Januvia is only rarely associated with adverse effects, the most common ones being cold-like symptoms such as headache, sore throat, and runny nose, and nausea or diarrhea. However, it has also been associated with pancreatitis, some cases of which have been fatal. A warning for pancreatitis has been included in the labeling for Januvia, though a true cause and effect relationship between Januvia and the development of pancreatitis has yet to be fully proven. Rare cases of anaphylaxis (allergic reaction), angioedema (swelling in the mouth and throat), and Steven-Johnson Syndrome (an allergic exfoliative condition) have also occurred.
Januvia should be avoided in people with a known hypersensitivity to any of its ingredients, as well as anyone with diabetic ketoacidosis, Type 1 Diabetes, or a history of pancreatitis. Available in doses of 25mg, 50mg, and 100mg, Januvia is also available combined with Metformin.
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