Has your doctor prescribed you a combination of sitagliptin and metformin for type 2 diabetes? In our country, this medication comes under the brand name Janumet. Since diabetes is a condition that needs to be managed properly, it is very important that you have a good understanding of the medication you are taking. So today, let's talk briefly about this medication, what it does to your body, and the things you need to be careful about while using it.
What really happens with this medicine?
Simply put, the two drugs in this pill help control your blood sugar levels (blood glucose) in two ways.
1. Sitagliptin: This helps increase your body's natural production of a hormone called insulin after you eat. Insulin is what helps sugar in the blood enter the body's cells and be used for energy.
2. Metformin: This mainly works by reducing the unnecessary production of sugar by your liver. It also increases the sensitivity of your body's cells to insulin. This means it helps you make the most of the insulin you have.
The most important thing is that taking this medicine alone is not enough. You also need to follow a good diet and exercise regularly . Only then can you get the best results.
Things you need to tell your doctor before starting medication
Your doctor will need to know your complete health history before prescribing any medication. So if you have any of the following conditions, be sure to tell them without hiding it. This is very important for your safety.
| Do you have these conditions? |
|---|
| Kidney disease or liver disease |
| Heart disease or heart failure conditions |
| If you have had pancreatitis before |
| High triglyceride levels in the blood |
| Low vitamin B12 level or anemia |
| Having a habit of drinking alcohol regularly |
| Being pregnant, planning to have a baby, or breastfeeding a baby |
| Having an allergy to any other medicine, food, or substance |
How exactly do I use this medicine?
- Swallow the pill with a glass of water.
- This is very important: Always take this pill with or after a meal . Taking it on an empty stomach may cause stomach discomfort (heartburn, nausea).
- Take only the prescribed dose, at the time prescribed by your doctor. Do not change the dose as you wish.
- Do not stop taking the medication suddenly without medical advice.
- If you miss a dose: Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Never take a double dose.
- If you take too much: If you think you have taken too much medicine by mistake, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital .
Things to be careful about when taking medicine
- Blood Sugar Levels: Learn how to measure your blood sugar levels. Be aware of the symptoms of low blood sugar (Hypoglycemia) and high blood sugar (Hyperglycemia).
- Low blood sugar (Hypoglycemia): This can be an emergency. If you experience symptoms such as sweating, shaking, extreme hunger, or dizziness, eat something sweet (a sugar cube, candy, or glucose tablet) immediately . If you become unconscious, inform your family that others should not force you to eat or drink, and that you should be taken to the hospital immediately.
- HbA1C test: Your doctor will ask you to have this blood test about once every 3 months. This measures how well you have been controlling your blood sugar over the past 2-3 months.
- Surgery and scans: If you are going to have surgery, an MRI, or a CT scan, tell the medical team ahead of time that you are taking this medicine. You may need to stop taking the medicine a few days before the procedure .
- Alcohol: Drinking alcohol increases the risk of sudden drops in blood sugar levels and a dangerous condition called lactic acidosis. So talk to your doctor about alcohol.
What are the possible side effects?
Like any medicine, this can cause side effects in some people. Most of the time, these are not serious, but there are some symptoms that you should be especially aware of.
| Serious symptoms that require immediate medical attention | |
|---|---|
| Lactic Acidosis Symptoms | Muscle pain or stiffness, stomach pain, shortness of breath, extreme fatigue. (This is a rare but very dangerous side effect of Metformin). |
| Pancreatitis | Severe pain in the upper abdomen, spreading to the back, vomiting, and fever. |
| Allergic Reaction | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing or swallowing. |
| Other serious symptoms | Severe joint pain, skin blisters or sores, difficulty breathing, swelling of the legs or ankles, sudden weight gain. |
| Common (non-serious) side effects | |
| Digestive system problems | Stomach upset, gas, diarrhea, nausea (often occurs early in the treatment and goes away later. This can be reduced by taking it with food). |
| Other | Headache, sore throat, runny nose. |
Take-Home Message
- Sitagliptin and Metformin are medications used to treat type 2 diabetes. To get the best results from this, a good diet and exercise regimen are essential.
- Always take this tablet with or after a meal .
- Be sure to tell your doctor about any other medications, vitamins, or traditional medicines you are taking.
- Be aware of the symptoms of low blood sugar (hypoglycemia) (shaking, sweating, dizziness). Keep something sweet nearby to take in case of such a situation.
- If you experience severe abdominal pain, difficulty breathing, or severe muscle pain, it could be a sign of a serious condition such as Lactic Acidosis or Pancreatitis . Go to a hospital's ETU immediately.
- Do not stop taking the medicine or change the dosage without medical advice. If you have any concerns, talk to your doctor.
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