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The body's interaction with Januvia and grapefruit

Thursday 19 March 2020
Diabetes

Medically reviewed by

Stefan Reiner, PharmD, RPh
on 1 September 2020

Table of contents


I. Januvia and grapefruit

II. Januvia overview

III. What's the deal with grapefruits?

IV. Side effects


Januvia & Grapefruit

Grapefruit is not only a refreshing breakfast, but the nutrients present in the fruit may have some health benefits. Grapefruits contain lots of fiber as well as 73% of your daily value vitamin C and 24% of your daily vitamin A. It is a healthy food choice in most cases. Still, it may be dangerous to consume if you are taking certain medications.

People are very interested in natural remedies for their complicated medical conditions. Type 2 diabetes can be a multi-faceted and expensive illness, so a lot of people are testing out the benefits of grapefruit juice. Patients may want to examine the risks and benefits of the fruit because the compounds in grapefruits are known to interact with dozens of medications. Read below for more information on the effect of grapefruit juice on the body and its interaction with prescription drugs.  [1]

Januvia overview

Januvia (sitagliptin) is a regularly used medication in regulating blood sugar levels in type 2 diabetes patients. A resistance to insulin characterizes type 2 diabetes.  This once-daily prescription drug helps the pancreas create more insulin. Type 2 diabetes medications paired with a healthy diet and exercise routines help improve symptoms. If some adverse health conditions can be rectified, then type 2 diabetes may fix itself over time.

Januvia helps with the production of insulin in the pancreas. In clinical studies, Januvia improved the A1C (blood sugar level) level of adult type 2 diabetes patients, bringing it to a healthy 7% in many cases. Drugs must undergo several tests and trials to get approved for patient consumption. Foods like grapefruit do not undergo the same extensive tests when it comes to their health benefits.

All prescription drugs have specific interactions with each other, and you should consult your doctor if you are taking a large number of herbs, supplements, or a particular food in a bid to combat your symptoms.  [2]

What’s the deal with grapefruits?

The grapefruit is a sweet and bitter fruit that was created over 300 years ago. Red grapefruits contain carbohydrates as well as plenty of vitamins. Grapefruits are low on the glycemic index, which makes them a popular choice for diabetics. The glycemic index is important because it ranks foods with carbohydrates and how they affect blood glucose levels. Carbs directly affect blood sugar, so you have to eat a consistent amount of carbohydrates throughout the day so as not to disrupt your blood sugar levels.

Most diabetics can have 45-60 (female) or 60-75 (males) grams of carbohydrates per meal. Grapefruits contain 52 calories and only 13 grams of carbs, so they are well within the daily limits. Moderation is essential, but that can be easy to forget if there are purported health benefits to specific food. [3]

In one 2006 study in The Journal of Medicinal Food, a group of obese people ate half of a grapefruit three times a day. The participants experienced improved insulin resistance by the end of the four-month study. This is one positive outcome, but it is unknown if these patients had type 2 diabetes. Their medical conditions or usage of medications like Januvia are unknown, so this study should be taken with a grain of salt.  

The consumption of grapefruit and its juice may cause certain drugs to become toxic due to its polyphenolic compounds. These effects are common in drugs that help lower cholesterol, treat high blood pressure, anti-anxiety medicines, as well as anti-diabetes drugs. Eating or drinking grapefruits and its juice is usually not a big deal, but heavy consumption can cause problems.  [4]

Side Effects

Several things occur when the body ingests grapefruit. Grapefruits contain furanocoumarins, which are a type of organic chemical compound that disrupts the efficiency of an essential enzyme in the body. These crucial enzymes break down drugs in the liver and small intestines. If the enzyme is inhibited, then large amounts of the drugs can circulate around your body. Medication levels can grow toxic if a lot of medication is left floating around the bloodstream. This sort of reaction is shared in a lot of citrus fruits like limes, pomelos, and Seville oranges, but grapefruit is the most studied for this reaction. [5]

In terms of Januvia, its effectiveness may be reduced if you eat a lot of grapefruit because the fruit can cause a spike in blood sugar, causing hyperglycemia. Januvia cannot work as well if you are constantly spiking and crashing your blood sugar. This condition can become severe if left untreated. Diabetic comas can occur if it’s left unchecked too long, and persistent hyperglycemia can lead to complications of the heart, kidneys, nerves, and eyes. [6]

 

different types of fruits lined up together

The exact effect of grapefruit can be hard to determine because the interaction depends on the polyphenolic content of the grapefruit, a patient’s metabolism, and the amount of fruit consumed. Most doctors will advise erring on the side of caution and abstaining from the consumption of grapefruit. Grapefruit juice can take over 72 hours to take effect on the bloodstream, so it is advisable to keep an eye on your blood sugar. [7]

Maintaining your blood sugar is the number one goal of successful type 2 diabetes treatments, so eating foods like grapefruit may be best in moderation. Like all medications, Januvia patients should always consult their doctors if they want to indulge in their love for grapefruit. Patients on any medication should pay attention to changes in their conditions when consuming food or supplements in larger than normal amounts.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.