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Januvia's Effect on Type 2 Diabetes

Wednesday 23 February 2022
7 minute(s) read
.Stefan Reiner

Medically reviewed by

Stefan Reiner, PharmD, RPh

on 23 February 2022

Table of Contents

I. Type 2 Diabetes Overview

a. Risk factors

II. Januvia Description & Trials

III. What to do before taking Januvia

IV. How to take Januvia

V. Side Effects

a. Hypoglycemia

b. Allergic reactions

c. Kidney problems

d. Joint pain

e. Pancreatitis

f. Other drugs

Type 2 Diabetes Overview

Januvia is an oral medication that helps with blood sugar levels. Januvia is used exclusively for type 2 diabetes mellitus. This medication does not treat type 1 diabetes. Type 2 diabetes occurs when the body becomes resistant to insulin, and the pancreas cannot create enough insulin. Many factors contribute to this disease. A person can inherit this condition, but it can also occur due to poor diet and exercise practices.

If proper diet and exercise can’t naturally get rid of type 2 diabetes, insulin treatments and medications can maintain the illness. Drugs like Januvia help maintain a good quality of life for those with this condition. Type 2 diabetes usually refers to adult-onset diabetes, but due to the rise of childhood obesity, it is becoming more common in children.

a. Risk Factors

As described above, an unhealthy lifestyle is one cause for type 2 diabetes, but there are a variety of factors that can lead to this condition. Fat distribution plays a large part in this illness. If you carry a lot of your fat in your abdomen, the risk increases. Men with a waist circumference of 40 inches or more, and women with a waist size of 35 inches or over, the risk of diabetes increases. Increased age also plays a significant role because you tend to exercise less and lose muscle mass as you get older.


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If a mother develops gestational diabetes while pregnant, she is more likely to develop type 2 later in life. Polycystic ovarian syndrome (PCOS) is known to also lead to this condition in some cases.  PCOS is characterized by irregular menstrual periods, weight gain, and sometimes infertility.  Some signs are harder to notice than others: Areas of darkened skin in the neck and armpits can also indicate insulin resistance. [1]

an insulin pump

Januvia Description & Trials

Sitagliptin is the generic name for Januvia. Sitagliptin works by increasing insulin release and decreasing glucagon (raises the concentration of fatty acids in the bloodstream). Glucagon levels slow the previously inactive incretin hormones (insulin stimulators) in the gut. Incretin hormones are released after a meal and stimulate pancreatic insulin secretion. This response can become delayed with diabetes, and Januvia is one such drug that regulates the incretin hormone response. [2]

Januvia is a once-daily prescription that helps adults with type 2 diabetes control their blood sugar levels. Metformin is a medication that often pairs with Januvia or used alternatively. Clinical studies for Januvia took place over 24 weeks, and followed adults whose A1C (blood glucose level test) levels are not controlled through metformin. The participants were given 100mg of Januvia/placebo, and significant results were found. Those who added Januvia to their daily meds found that their A1C levels lowered an average 0.7%, whereas the placebo reduced at 0%.

The participants in this study had an unhealthy A1C level of 8%. The normal range for A1C levels is between 4% and 5.6%. The lowering of A1C is an improvement, but the real success was found when many reached their A1C goal of less than 7%. This healthy goal was met by 47% of the participants in the study. A1C levels can be individual to the patient, so consulting a doctor is recommended. [3]

What to do before taking Januvia

Like all medications, Januvia has risks and benefits, so proper dosage by your doctor is necessary. This medication treats type 2, not type 1 diabetes, and so do not take this medication if you have type 1. You should also tell your doctor if you suffer from ketoacidosis. Ketoacidosis is a severe complication that results from increased ketones, which are molecules that cause high levels of blood acids. When a person has diabetes, this condition can develop when there is not enough insulin in the cells, so your body begins to break down fat as fuel. This buildup of acids in the blood then leads to ketoacidosis. [4]

Healthy-functioning kidneys are also important when starting Januvia because diabetes is the leading cause of kidney disease. The kidneys filter wastes and toxins out of the blood to make urine as well as regulate hormones and blood pressure. Kidney problems often coincide with diabetes because high blood glucose levels damage the blood vessels in the kidneys over time. {{5}}

A healthy pancreas is also essential when beginning Januvia. The pancreas is essential in the digestive system and produces enzymes (like insulin) that help the body digest food. If you have diabetes, the pancreas is not creating enough insulin, so glucose can build up in the bloodstream. This complication can lead to long term effects like hyperglycemia (high sugar levels) and pancreatitis in more severe cases. Your doctor will tell you if you are healthy enough to start this treatment. {{6}}

How to take Januvia

Your doctor will prescribe whatever dose is necessary for your unique condition, but the most common form is a once daily 100mg dose. Januvia can be taken with or without food. It is important to stay on your healthy diet and exercise plan in order to maintain a healthy system overall. Your doctor may also take regular blood samples to make sure you are adjusting to this new medication properly. Life can get busy and if a patient forgets to take a dose, take it as soon as possible and then resume a regular schedule.

Do not take two doses at the same time. If you take more than two doses of Januvia in a day, it is recommended to call your local emergency healthcare provider or doctor. If this drug is effective for a patient, it can become a long term medication for the ongoing treatment of type 2 diabetes.  {{7}}

Side Effects

Side effects of this drug depend on the patient’s pre-existing health conditions as well as the severity of their type 2 diabetes symptoms. Many, many factors can lead to side effects. The most common include headache, runny or stuffy nose, and upper respiratory infections. The more severe side effects are listed below.

a. Hypoglycemia

Hypoglycemia is a condition caused by very low blood sugar (glucose). Glucose is the body’s energy source, so a lack of this substance can cause severe problems for the body. Less sugar reaching the cells and organs can cause the organs to work less efficiently. Some symptoms of hypoglycemia are hunger, weakness, drowsiness, headache, dizziness, and sweating. Januvia rarely causes this side effect; only 1.2% in the Januvia clinical study experienced these symptoms.

b. Allergic reactions

Mild allergic reactions like itchiness, flushing, and a skin rash can appear. More severe reactions like Steven-Johnson syndrome can occur with Januvia. Painful sores of the eyes, throat, and genitals characterize this syndrome. If you experience symptoms like trouble breathing or swelling of the tongue, mouth, or throat, you may be experiencing anaphylaxis and should seek medical help. Swelling under the skin of the lips, hands, or feet can indicate angioedema, which develops in more severe reactions.

c. Kidney problems

In clinical studies, there have been no direct links to Januvia and kidney problems. Sometimes the use of Januvia can hinder kidney function, resulting in long-term nausea and the swelling of legs, ankles, and feet. Tell your doctor if you experience unexplained chest pain because this can be an early sign of kidney failure. 

a replica of a kidney

d. Joint pain

Again, there are no clinical links to the correlation between Januvia and joint pain, but it has been reported as a side effect with some patients. You may experience joint pain and stiffness in your legs. In some cases, patients have been unable to move their joints.

e. Pancreatitis 

Pancreatitis is always a worry for diabetes patients and can sometimes present itself with the use of Januvia. In 19 clinical studies, 0.1% of those who took this medicine developed pancreatitis. This condition causes swelling of the pancreas, rendering the organ unable to make insulin as efficiently.

f. Other drugs

Januvia often pairs with other diabetes medications, so you must be mindful of the other drug’s side effects. Other drugs, supplements, herbs, and even grapefruit juice can cause interactions with Januvia. Patients should contact their doctor for further information on the interaction of their medications. {{8}}

The content provided in this article is based on thorough research and in some cases, reviewed by a medical professional. Our goal for the information is to provide helpful, general health informational. It is not intended as a substitute for professional medical advice.