DEAR DR. GOTT: I am a woman, age 82 and have had several high blood sugar readings over the past two years. Today my doctor wants to put me on Januvia, 50 mg once daily. My last two lab tests were 8.3 and 8.1 respectively. I am a notorious eater of candies and cookies, particularly anything chocolate. I am guilty of procrastination, do not exercise on a regular basis and at 5’5” am about 20 pounds overweight. Having just read of all the possible side effects of this medication, I am extremely reluctant to take it. I take 30 mg of lisinopril in combination with 2.5 mg generic for Norvasc for high blood pressure, which seems to be well under control. It is normally between 120-135/67-70. I also take Buspar 10 mg in the morning and 15mg at night, pravastatin 10mg at night, and an 81mg aspirin on alternate mornings (I still bruise easily).
I know what I need to do and will try to modify my diet, getting rid of the sweets (that will be almost as hard as pulling hen’s teeth!) and incorporating more veggies in my meals. My question to you is in regards to the Januvia. Are there older, more tried-and-true medications with far better safety records?
I miss your column in my daily paper but am glad you are still available online. Though I don’t have time to use it regularly, I am grateful for the internet. Thank you for all your good advice over the years. I have saved many of the articles.
DEAR READER: Before starting Januvia used in the treatment of type 2 diabetes, I urge you to speak with your primary care physician. Modifying your diet and exercise habits may be all that is necessary, especially since you already admit to over-indulging in sweets and sugary snacks. If you can eliminate most or all of the unnecessary sugars you’re blood sugars levels should drop.
If that fails to work, your physician should consider delving further into your medications, as several carry the possibility of side effects of the conditions you are currently experiencing.
Buspar is an anti-anxiety drug. Side effects include hypertension (high blood pressure).
Amlodipine, the generic form of Norvasc, is used in the treatment of hypertension and/or coronary artery disease. One of the less common side effects of this drug is hyperglycemia (high blood sugar).
Lisinopril is also used for in the treatment of hypertension as well as heart failure and is often prescribed following a heart attack. Among it’s side effects are diabetes mellitus, nervousness and mood alternations.
Pravastatin, the generic for Pravachol, is used in the treatment of high cholesterol and for the prevention of cardiovascular disease in those with risk factors. Side effects include anxiety and nervousness.
You don’t say how long you have been on any of these medications so I cannot determine if you are merely experiencing side effects or if you actually have the illnesses for which the drugs were prescribed. If you truly do have diabetes, diet and exercise, combined with a diabetes drug such as metformin, should bring your numbers back into the normal range. Januvia is newer and therefore may seem more appealing; however, metformin is older and a standard of care for many diabetics.
Readers who are interested in learning more can order my Health Reports “Hypertension”, “Consumer Tips on Medicine” and “Diabetes Mellitus” by sending a self-addressed, stamped number 10 envelope and a $2 (for each report) US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from my website, www.AskDrGottMD.com.
