Our reader Mishelle commented here, “I don’t eat [much] during the day. [I take metformin morning and night.] My blood sugar is still too high in the morning…sometimes 125–140ish.” How can Mishelle’s glucose levels go up if she didn’t eat anything? Her glucose is going up from sources other than digested food. Some of it is produced by the liver from stored starch and fatty acids. Livers that produce too much glucose are one of the main ways diabetes causes high blood glucose levels. Other organs also produce small amounts of glucose. This is called “gluconeogenesis” for you science freaks out there. Organs do this to keep blood glucose from going too low at night or other times of not eating. Metformin (brand names Glucophage, Glucophage XR, Fortamet, Riomet, Glumetza, and others) is a popular and highly effective oral diabetes drug used to help manage Type 2 diabetes. This drug works by lowering the amount of glucose made by the liver and by making the body’s cells more sensitive to insulin. Metformin also has some other beneficial effects in that it may help lower blood lipid, or fat, levels (cholesterol and triglycerides) and can, in some people, promote a small amount of weight loss. Metformin can be used with other diabetes pills and with insulin. Side effects of taking metformin are relatively rare, the most common being bloating, nausea, and diarrhea, all of which are temporary. Some people shouldn’t take metformin, including people with kidney disease, liver disease, or congestive heart failure, for example, because of an increased risk of a potentially fatal condition called lactic acidosis. In recent years, there’s been some concern over the risk of vitamin B12 deficiency in people who take metformin.
MUNICH -- For type 2 diabetes patients uncontrolled on metformin and sitagliptin (Januvia), adding the novel sodium/glucose cotransporter 2 (SGLT2) inhibitor ertugliflozin improved glycemic levels, a trial showed. Hb A1c improved by 0.7 percentage points with the lower 5 mg dose and by 0.8 percentage points with the higher dose compared with placebo on a background of metformin and the dipeptidyl peptidase-4 (DPP-4) inhibitor , both significant at Those were "clinically meaningful reductions," Brett Lauring, MD, Ph D, of drug developer Merck in Kenilworth, N. J., and colleagues reported in the VERTIS SITA2 trial here at the European Association for the Study of Diabetes meeting. Secondary endpoints also showed significant differences from placebo for the following: With three SGLT2 inhibitors already available, one member of the audience questioned why develop yet another. "With more agents, there's more choice on the marketplace for patients," answered Lauring, who added that differences have emerged among agents in some classes, like the DPP-4 drugs, and it's possible that the large cardiovascular outcomes trial program with ertugliflozin will be required to see if there is such a difference in the SGLT2s too given the "pretty compelling efficacy with this agent." Also, a fixed dose combination is attractive for patients, he added, having noted that "SGLT2 and DPP-4 inhibitors have differing, complementary mechanisms of action, and additive efficacy is expected." Clifford J. Bailey, Ph D, of Aston University in Birmingham, England, called the findings "consistent with effects of other members of class" but cautioned that it's "not possible to make specific comparisons with other members of the class in other studies as populations and other aspects of the studies will differ." The VERTIS SITA2 trial included 263 type 2 diabetes patients with inadequate glycemic control (A1c of 7.0% to 10.5%) on metformin dosed at 1,500 mg/day or greater and sitagliptin at 100 mg/day. They were randomized to the addition of ertugliflozin at either 5 or 15 mg or placebo for 26 weeks. Metformin and sitagliptin are oral diabetes medicines that help control blood sugar levels. Metformin works by decreasing glucose (sugar) production in the liver and decreasing absorption of glucose by the intestines. Sitagliptin works by regulating the levels of insulin your body produces after eating. Metformin and sitagliptin is a combination medicine that is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. metformin and sitagliptin is not for treating type 1 diabetes. Metformin and sitagliptin may also be used for purposes not listed in this medication guide. You should not use this medicine if you have severe kidney disease or diabetic ketoacidosis (call your doctor for treatment).
Sep 16, 2016. MUNICH -- For type 2 diabetes patients uncontrolled on metformin and sitagliptin Januvia, adding the novel sodium/glucose cotransporter 2. May 16, 2018. Metformin and sitagliptin is a combination medicine that is used together with diet and exercise to improve blood sugar control in adults with.