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Sitagliptin (Januvia) Lowers Blood Sugar in People With Type 1 Diabetes


Jan 7, 2011

Sitagliptin (Januvia) has long been used to reduce blood sugar in people with type 2 diabetes, but a new study indicates that it can do the same for those with type 1 diabetes. Sitagliptin is a DPP-4 inhibitor; that is, it inhibits, or temporarily prevents, the enzyme DPP-4 from destroying a helpful hormone called GLP-1. GLP-1, which is released by the gut when food arrives there from the stomach, lowers blood sugar by causing the release of insulin, reducing the secretion of glucagon, and slowing stomach emptying and nutrient absorption.

Unfortunately, GLP-1 is broken down by DPP-4 after only about a minute of beneficial action. Because GLP-1 could lower blood sugar a lot more if DPP-4 weren't so efficient at destroying it, a DPP-4 inhibitor such as sitagliptin comes in very handy for people with type 2 diabetes. Until now, however, it has not been tested in people with type 1 diabetes.

Now, a small pilot study conducted by Satish Garg, MD, of the University of Colorado, has found that sitagliptin lowers blood sugar in inadequately controlled type 1s as well. The 20 type 1 subjects were given 100 mg of sitagliptin daily or a placebo for four weeks, then switched to the alternate treatment for four more weeks. The sitagliptin lowered their mean blood glucose by about 12 mg/dL and their A1Cs by 0.27%, and they were able to cut their insulin dose by nearly 10 percent during the treatment period.

Dr. Garg plans to firm up his findings with a four-month multicenter study of sitagliptin in 120 type 1 patients.

***

Source:

Renal and Urology News


Categories: A1c Test, Blood Glucose, Blood Sugar, Diabetes, Diabetes, Food, Insulin, Medications, Medications Research, Type 1 Issues, Type 2 Issues, Type 2 Medications



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Comments

Posted by jlconrod on 9 January 2011

I have had Type 1 DM for 40 years which is brittle despite close blood glucose monitoring and Intensive Conventional Therapy (ICT) with Apidra and Lantus. My physician started me on a similar private clinical trial of Onglyza (saxaglyptin) for Type 1. My results were positive, reducing blood glucose extremes by 20% or more with no incidents of extreme hypoglycemia.

As an alternative therapy I am now testing Januvia (sitaglyptin), similar to the Dr. Garg's Colorado study. In my case Januvia has also resulted in the 20% improvement in reducing hyperglycemia with rare but mild hypoglycemia episodes. Both I and my Diabetologist have been impressed with these responses.

The initial trial with Onglyza lasted about 8 weeks. I have been in the Januvia trial for five weeks so far. Objectively both sitaglyptin and saxaglyptin have produced positive effects. Subjectively, I seem to prefer Januvia.

We will review the results of both trials at my next physician visit and decide which therapy to use. Hopefully these studies will result in either Onglyza or Januvia will be labelled for use in Type 1 and added to the Medicare formulary.

I would like to see large scale clinical trials to speed the approval process. My family has a history of brittleness in Type 1 unrelated to diet or insulin therapies. These glyptin private trials add a significant tool in improving insulin response and blood glucose management.

Posted by jlconrod on 9 January 2011

I have had Type 1 DM for 40 years which is brittle despite close blood glucose monitoring and Intensive Conventional Therapy (ICT) with Apidra and Lantus. My physician started me on a similar private clinical trial of Onglyza (saxaglyptin) for Type 1. My results were positive, reducing blood glucose extremes by 20% or more with no incidents of extreme hypoglycemia.

As an alternative therapy I am now testing Januvia (sitaglyptin), similar to the Dr. Garg's Colorado study. In my case Januvia has also resulted in the 20% improvement in reducing hyperglycemia with rare but mild hypoglycemia episodes. Both I and my Diabetologist have been impressed with these responses.

The initial trial with Onglyza lasted about 8 weeks. I have been in the Januvia trial for five weeks so far. Objectively both sitaglyptin and saxaglyptin have produced positive effects. Subjectively, I seem to prefer Januvia.

We will review the results of both trials at my next physician visit and decide which therapy to use. Hopefully these studies will result in either Onglyza or Januvia will be labelled for use in Type 1 and added to the Medicare formulary.

I would like to see large scale clinical trials to speed the approval process. My family has a history of brittleness in Type 1 unrelated to diet or insulin therapies. These glyptin private trials add a significant tool in improving insulin response and blood glucose management.

Posted by jlconrod on 9 January 2011

I have had Type 1 DM for 40 years which is brittle despite close blood glucose monitoring and Intensive Conventional Therapy (ICT) with Apidra and Lantus. My physician started me on a similar private clinical trial of Onglyza (saxaglyptin) for Type 1. My results were positive, reducing blood glucose extremes by 20% or more with no incidents of extreme hypoglycemia.

As an alternative therapy I am now testing Januvia (sitaglyptin), similar to the Dr. Garg's Colorado study. In my case Januvia has also resulted in the 20% improvement in reducing hyperglycemia with rare but mild hypoglycemia episodes. Both I and my Diabetologist have been impressed with these responses.

The initial trial with Onglyza lasted about 8 weeks. I have been in the Januvia trial for five weeks so far. Objectively both sitaglyptin and saxaglyptin have produced positive effects. Subjectively, I seem to prefer Januvia.

We will review the results of both trials at my next physician visit and decide which therapy to use. Hopefully these studies will result in either Onglyza or Januvia will be labelled for use in Type 1 and added to the Medicare formulary.

I would like to see large scale clinical trials to speed the approval process. My family has a history of brittleness in Type 1 unrelated to diet or insulin therapies. These glyptin private trials add a significant tool in improving insulin response and blood glucose management.


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