Are you being treated for Type 2 Diabetes Mellitus? If so, your doctor may have prescribed you a pill that combines two drugs called Linagliptin and Metformin. This is commonly seen in our country under the brand name Jentadueto. This is a very effective medicine that helps control blood sugar levels (glucose). However, like any medicine, there are some things we need to be careful about while using it. Let's talk about it simply today, in a way that you can understand.
What really happens with this combination of medications?
I said this is a combination of two medications. Let's see what happens with the two separately.
- Metformin: This mainly works by reducing the amount of sugar your liver makes. It also increases the sensitivity of your body's cells to insulin. Simply put, it helps your body make the most of the insulin it has.
- Linagliptin: This works by stimulating the body's production of insulin in response to a meal.
When these two medications work together, they can help you control your diabetes. But remember, this medication alone is not enough. In addition to this , proper diet and exercise are also essential.
Things you need to tell your doctor before starting medication
Before prescribing this medicine to you, it is very important that your doctor knows your complete health history. This is because we need to be very careful when using this medicine with certain medical conditions. If you have any of the conditions below, be sure to inform your doctor about it.
| Disease or condition | Why should you inform? |
|---|---|
| Kidney disease or liver disease | Metformin is eliminated from the body through the kidneys. If the kidneys are not functioning properly, the drug can build up in the body and cause a serious condition (lactic acidosis). |
| Heart disease or heart failure | Special care should be taken when giving this medication to some heart patients. |
| Frequent drinking | Combining alcohol and Metformin greatly increases the risk of a dangerous condition called lactic acidosis. |
| Having a history of pancreatitis | Linagliptin has a very rare risk of pancreatitis. It is important to inform your doctor if you have had this condition in the past. |
| Vitamin B12 deficiency or anemia | Long-term use of metformin may reduce the body's absorption of vitamin B12. |
| Being pregnant or trying to get pregnant, breastfeeding | This medicine is not suitable during pregnancy and breastfeeding. There are other treatments available. |
| Other situations | Tell your doctor if you have Diabetic Ketoacidosis, gallbladder disease, high triglyceride levels, severe infections, Polycystic Ovary Syndrome (PCOS), thyroid disease, or any allergies to any medications or foods. |
How exactly do I use this medicine?
- Take with food: This is the most important thing. Metformin can cause stomach upset and nausea in some people. Taking the medicine with or immediately after a meal can greatly reduce these discomforts.
- Drink with a glass of water: Swallow the tablet whole with a glass of water.
- Follow your doctor's instructions: Take the dose prescribed by your doctor, at the prescribed time. Do not reduce, increase, or stop the dose on your own.
- If you forget to take a dose: If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at the same time.
- Overdose: If you think you have accidentally taken too much medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital or go to the Emergency Department (ETU) of the nearest hospital. Do not take this lightly.
The most important thing is to give your doctor a complete list of all the medications you take (including vitamins, Panadol, Ayurvedic medicines, herbal products) so he can see if you have any problems.
Things to keep in mind when taking medication
Monitoring sugar levels
Your doctor will ask you to have a blood test called HbA1C every 3 to 6 months. This will look at your average blood sugar control over the past 2-3 months. Also, learn how to check your blood sugar levels at home if possible.
Low blood sugar (Hypoglycemia)
Sometimes, when taking this medicine, your blood sugar level may become too low. Symptoms of this include:
- Sudden sweating
- Tremor
- Inability to concentrate
- Dizziness and extreme hunger
If you experience these symptoms, immediately eat something sweet (a sugar cube, glucose tablet, or a sweet drink). So always keep something like a sugar cube with you. If you lose consciousness, tell your family not to put anything in your mouth. If this happens, you should immediately go to the hospital.
Surgeries and scans
If you are having any surgery, CT scan, or MRI scan, tell the medical team in advance that you are taking this medicine. You may need to stop taking the medicine a few days before the test.
What are the possible side effects?
Like any medicine, this one can have side effects. But not everyone gets them. The most important thing is to recognize the signs of a serious side effect and act quickly.
| Side effect | What to do? |
|---|---|
| Serious conditions that require immediate medical attention | |
| Allergic Reaction: Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. | Go to the hospital's Emergency Treatment Unit (ETU) for immediate treatment. |
| Lactic Acidosis: (rare but very dangerous) - muscle pain, stomach pain, difficulty breathing, extreme fatigue, general lethargy. | These are the most serious side effects of Metformin. Go to the ER immediately. |
| Pancreatitis: Severe stomach pain (especially radiating to the back), pain that worsens after eating, vomiting, fever. | See a doctor immediately or go to the ETU. |
| Heart Failure Symptoms: Shortness of breath, swelling of the ankles and feet, sudden weight gain, extreme fatigue. | See your doctor immediately. |
| Conditions that are usually not serious, but should be reported to the doctor if they persist | |
| Diarrhea | It often comes and goes in the early stages. If it persists or is severe, tell your doctor. |
| Cold-like symptoms (runny nose, sore throat) | If these are bothersome or persist, talk to your doctor. |
Take-Home Message
- Always take this medicine with or after a meal . This will greatly reduce stomach discomfort.
- Do not stop taking the medication or change the dosage without your doctor's advice.
- Inform your doctor about all other medications you are taking (including vitamins and Ayurvedic medicines).
- Be aware of the symptoms of low blood sugar (hypoglycemia) (sweating, shakiness, dizziness ). Keep something sweet nearby to eat in case of such a situation.
- If you experience serious symptoms such as severe stomach pain or difficulty breathing , go to a hospital immediately.
- See your doctor on time and get tests like HbA1C done to keep your diabetes under control.
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