November
2007
New Type II Diabetes Pill: Januvia
Type 2 Diabetes means the body is resistant to insulin. The body makes insulin, but usually due to obesity the body doesn’t respond to insulin well anymore. So the pancreas cranks out more and more insulin to compensate for this need, but in time it is not enough.
Over 7% American adults have diabetes. Since 1990 Type II diabetes has been dramatically increasing in children and adolescents due to obesity. 14% of US health care costs are from diabetes. Overall costs to USA is about 132 billion dollars as of 2002. Fasting blood glucose of 126 or more is diabetes, or a HbA1C of 6% or more.
So, Januvia (sitagliptin) has been out in the market for over the past year to help those with Type II diabetes who aren’t getting enough control on metformin (a commonly used medicine for type 2 diabetes). So what is it? Oh, boy, here is my best explanation.
Incretins are intestinal hormones that are released when there is food in the gut. Incretins GLP-1 (glucoagon-like peptide-1) and GIP (glucose-dependent insulinotropic peptide) do the following: lowers glucagon secretion, slows the GI system, and increases satiety. Also they stimulate secretion of insulin
Dipeptidyl peptidase-4 (DDP-4) “digests” GLP-1 and GIP, so Januvia inhibits
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drjohnhong 
diabetes, Endocrinology 
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