Diabetes Medications

My internal medicine physician recently recommended Januvia,since my HbA1c had gone up to 7.4. But I lost 12 lbs since then and increased metformin to 1000mg at 9pm. last HbA1c was 6.9. increased my exercise - walking. very strict diet of low carbs, increased salads and vegs. My readings are highest in morning on awakening at 130 - 150 and seem to drop rest of day. 100 is the lowest I go. Diabetes type 2 for 12 years managed with diet and exercise till 4 yrs ago and started on metformin and have had to increase dosage several times due to concern about my hba1c going higher. lost my endocrinologist 2 yrs ago - she retired.
question about januvia since it is new?  or what else can I take? Thanks for your help.

[Anita Ramsetty, MD]

Hi,
Congratulations on losing weight on your own and managing to implement all those lifestyle changes. They are not eay to make, so you should be commended.

Your current control is quite good, but can be better. Januvia is a new medication and overall has few side effects known at this time. It is usually used in combination with metformin(there is actually a combo pill called Janumet) or other oral medications. Other than Januvia, there are many other oral medications that can be added to Metformin(too many to name here actually). You are already below 7%, which  is the general target, so there is no huge pressing need to tighten your glucose control at this time, but if you can get closer to an A1C of 6.5%, that would be even better for your health. Be sure to look out for any hypoglycemia  that may occur as you add medications. And definitely keep up with the dietary and exercise changes that you have made.

Hope this helps,
take care.

[redroseva]

Thanks for your reply. I appreciate your comments.
My next blood work is in a few weeks and I am hoping to have the results even better than 6.9. However I now have bronchitis and have seen some high bl sugars for a few days. better today. but have sugar cravings when I am sick. Got my sugar free jello and choc pudding made which helps.