[musicteacher]

Hello my name is Marianne. I have had Type 2 Diabetes for a few years. I was doing really well with good blood sugars on 4 Metformin a day. After some blood tests it looks like my kidney function GFR? is at 50. Now the doctor has told me to only take 2 metformin a day. This has caused my blood sugars to rise. It is now suggested that I add one Januvia to the 2 metformin. I have read of scary side effects of Januvia and am so reluctant to take it. Where can I find peoples' experiences with Januvia? Thanks for any help you can give me.

[mrsD]

Rather than go to more oral medications, it might be best to cut to the chase as many doctors are doing today, and get on a low dose of long acting basal insulin. You could start at a low dose and work up to where you need to be. The new dosing pens are easy to use and store. And I think you would get better results.

Since you were on metformin in high dose for a while, I'd also suggest you get evaluated for your B12 levels. They should be at 400 or above, and if below that, (US still reports low levels as "normal"), take a supplement. Metformin causes low B12 to occur in about 40% of patients. So it would be a very good idea to have this evaluated.

Once kidney functions change Metformin is not an option anymore.

What were your A1C's levels like?

[NurseNancy]

hi marianne,

i'm not nearly as knowledgeable as mrs d. she has given you some great advice.

it might also be time to see an endocrinologist. they usually specialize in these things.

you also might ask your pharmacist about your meds. they can give you some great advice. and, you could ask for the drug Co. handout for januvia. read it top to bottom and you'll learn a lot.

hang in there. there's a good combination out there for you.

[musicteacher]

Thank you Mrs D for your advice. I think too that insulin will not be far down the road. My HbIAc has gone from .65 on the 4 metformin to .72 on the reduced Metformin. Thanks for the other reply as well. I will read up a bit more on Januvia.

[Darlene]

marianne,

Happy to see you have come to be with us. Just let us know if we can be of any help. There are great and caring friends here to assist you. Our shoulders are here for support in many ways. Seems you have been through some ruff times. Please keep us up to date.

Again welcome, looking forward to seeing you around. My thoughts and prayers are with you.

Darlene