Tuesday, October 2, 2007
GOOD NEWS:THERE IS A NEW THERAPY FOR PATIENTS WITH TYPE 2 DIABETES
Januvia (sitagliptin) is an orally active, potent, and highly selective inhibitor of the dipeptidyl peptidase 4 (DPP-4) enzyme. It can be used as monotherapy or in combination with metformin or a peroxisome proliferator activated receptor gamma(PPAR gamma) agonist(eg, thiazolidinedione) .
The recommended dose of Januvia is 100mg once daily as monotherapy or as combination therapy.
The side effects of Januvia was generally well-tolerated in controlled clinical studies as both monotherapy and in combination therapy, with the overall incidence of side effects similar to that reported with placebo.
What is the mechanism of action ?
Incretins are gut hormones that help the body respond to elevated glucose. Incretin levels increase in response to meals. When glucose levels are elevated, increased incretin secretion leads to increased insulin release and suppressed glucagon secretion.Incretins are released throughout the day but are degraded rapidly by DPP-4 enzyme.
In type 2 diabetes , despite increased blood glucose, the incretin effect is diminished. Diminished incretin effect leads to...
:Reduced beta-cell release of insulin.
:Nonsuppressed alpha-cell secretion of glucagon.
:Inability to regulate glucose.
Therefore,it will lead to Hyperglycemia.
Now,by inhibiting DPP-4, Januvia increases active incretins to enhance the body's physiological response i.e.
:Increases insulin secretion in a glucose-dependent manner.
:Suppresses glucagon secretion in a glucose-dependent manner.
:Improve glucose control, with glucose reductions only when they are needed.
According to medical representative, the price of Januvia 100mg per box(28's) is RM220.
Before initiating therapy, please consult your reliable physician.