Sitagliptin is an oral drug that reduces blood glucose levels in patients with type 2 diabetes. Following a meal, incretin hormones such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are released from the intestine, and their levels increase in the blood. GLP-1 and GIP reduce blood glucose by increasing the production and release of insulin from the pancreas. GLP-1 also reduces blood glucose by reducing the secretion by the pancreas of glucagon, a hormone that increases the production of glucose by the liver and raises the level of glucose in the blood. The net effect of increased release of GLP-1 and GIP is to reduce blood glucose levels. In addition, sitagliptin inhibits the enzyme, dipeptidyl peptidase-4 (DPP-4) that destroys GLP-1 and GIP and thereby increases the levels and activity of both hormones and thereby the release of insulin. As a result, blood glucose levels fall.
SIDE EFFECTS AND PRECAUTIONS: The most common side effects of Janumet are:
Lactic acidosis is a serious side effect of metformin that occurs in one out of every 30,000 patients and is fatal in 50% of cases. The symptoms of lactic acidosis are weakness, trouble breathing, abnormal heartbeats, unusual muscle pain, stomach discomfort, light-headedness and feeling cold. Patients at risk for lactic acidosis include those with reduced function of the kidneys or liver, congestive heart failure, severe acute illnesses, and dehydration. Janumet should be discontinued immediately if lactic acidosis is suspected.
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