Diabetes and Lipid Clinic of Alaska



GLP Analogues- Januvia,Onglyza,Tradjenta

The GLP-1 incretin is a naturally occurring hormone that is concerned with energy balance in the body. It is secreted by the gut in response to food consumption. GLP-1 functions to maintain blood glucose levels by increasing insulin production in the pancreas, decreasing the release of glucagon (a hormone which controls the release of glucose from the liver after meals), promoting a feeling of fullness after eating a meal and slowing the emptying of the stomach’s contents to allow more time for food absorption. The GLP-1 hormone is deficient in persons with diabetes. GLP-1 analogues are synthetic, structurally altered versions of the naturally produced GLP-1 hormone. Unlike naturally produced GLP-1, which is rapidly inactivated by an enzyme called DPP-4, synthetic GLP-1 analogues are designed to have much longer lasting effects. Therefore, high levels of GLP-1 activity may be achieved in persons with diabetes by injecting a GLP-1 analogue. The use of GLP-1 analogues as treatment for type 2 diabetes is currently undergoing extensive clinical trials.

These medications lower high blood sugar levels after eating a meal and decrease the amount of glucose produced by your body. They also maintain blood glucose levels between meals as well as increasing insulin production in a glucose dependent manner, meaning that it does not stimulate the production of insulin if glucose levels are low. This minimizes the risk of hypoglycemia (low blood sugar). DPP-4 inhibitors work by inhibiting the activity of DPP-4, which then increases the activity of GLP-1 in your body. Insulin production in your pancreas is then able to increase and the production of glucose in your liver decreases.

 Proper Usage of DPP-4 inhibitors

  • Like any prescription medication, it is important to take medications exactly as prescribed by your doctor.
  • If you miss a dose of your medication, take it as soon as you remember. If you do not remember until it is time for your next dose, skip the missed dose and continue on your regular schedule. Do not take a double dose on the same day.
  • Stay on your prescribed diet and exercise program.
  • Monitor your blood sugar as your instructed by your doctor.
  • DPP-4 inhibitors may be prescribed alone or with certain other diabetes medications. Follow your doctor’s instructions as to what would be the most effective treatment for you.
  • Your doctor will monitor your diabetes with regular blood tests, including your blood sugar levels and your hemoglobin A1C
  • Talk to your doctor about how to prevent, recognize and manage low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and complications of diabetes. 

Before using this medication

Before taking DPP-4 inhibitors, talk to your doctor about all prescription and non-prescription medications you are currently taking and/or if any of the following conditions apply to you:

  • You have type 1 diabetes. These medications are only for Type 2 diabetics
  • You have or have had diabetic ketoacidosis (increased ketones in the blood or urine)
  • You have congestive heart failure
  • You have or have had kidney problems. Your doctor may perform blood tests on you from time to time to measure how well your kidneys are functioning.
  • You have liver problems
  • You are pregnant or plan to become pregnant.
  • You are breast-feeding or plan to breast-feed .

Side Effects

There are very few known side effects associated with the use of DPP-4 inhibitors. The most common side effects include:

  • Stuffy/runny nose
  • Sore throat

They may occasionally cause stomach discomfort and diarrhea.

The following additional side effects have been reported in general use with DPP-4 inhibitors:

  • Allergic reactions, which may be serious, including rash, hives, and swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. If you have an allergic reaction, stop taking Januvia and call your doctor right away. Your doctor may prescribe a medication to treat your allergic reaction and a different medication for your diabetes.
  • Elevated liver enzymes
  • Inflammation of the pancreas

Warnings and Precautions

  • DPP-4 inhibitors are not recommended for children under 18 years of age
  • They are not recommended for use during pregnancy or breast-feeding
  • Contact your doctor if you develop abdominal pain
  • Do not stop taking medications without consulting your doctor
  • When your body is under some types of stress, such as fever, trauma, infection or surgery, the amount of diabetes medicine that you need may change. Tell your doctor right away if you have any of these conditions and follow your doctor’s instructions.
  • Remember that your physician has prescribed this medication only for you. Do not give medications to anyone else, even if they have the same symptoms that you do

For more information, please consult with the medical professionals at Diabetes and Lipid Clinic of Alaska.

The information on this Web page is provided for educational purposes. You understand and agree that this information is not intended to be, and should not be used as, a substitute for medical treatment by a health care professional. You agree that Diabetes and Lipid Clinic of Alaska is not making a diagnosis of your condition or a recommendation about the course of treatment for your particular circumstances through the use of this Web page. You agree to be solely responsible for your use of information contained on this Web page

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