OMUDHOME OGBRU, Pharm.D.Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. Dr. graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Sitagliptin is an oral drug that reduces blood
sugar (glucose) levels in patients with type 2 diabetes. Sitagliptin is the
first approved member of a class of drugs that inhibit the enzyme, dipeptidyl
peptidase-4 (DPP-4).
Following a meal, incretin hormones such as glucagon-like peptide-1 (GLP-1)
and glucose-dependent insulinotropic polypeptide (GIP) are released from the
intestine, and their levels increase in the blood. GLP-1 and GIP reduce blood
glucose by increasing the production and release of insulin from the pancreas.
GLP-1 also reduces blood glucose by reducing the secretion by the pancreas of
the hormone, glucagon, a hormone that increases the production of glucose by the
liver and raises the blood level of glucose. The net effect of increased release
of GLP-1 and GIP is to reduce blood glucose levels. Sitagliptin inhibits the
enzyme, DPP-4, that destroys GLP-1 and GIP and thereby increases the levels and
activity of both hormones. As a result, blood glucose levels fall. In summary,
sitagliptin reduces blood glucose levels by inhibiting DPP-4 and increasing the
levels of GLP-1 and GIP. Sitagliptin was approved by the FDA in October, 2006.
GENERIC AVAILABLE: No
PRESCRIPTION: Yes
PREPARATIONS: Tablets: 25, 50, and 100 mg
STORAGE: Tablets should be stored at room temperature, 15-30°C (59-86°F)
PRESCRIBED FOR: Sitagliptin is combined with
diet and exercise to improve
blood glucose levels in patients with type 2 diabetes. Sitagliptin may also be
combined with metformin, rosiglitazone or pioglitazone.
DOSING: Sitagliptin may be taken with or without food. The recommended dose
is 100 mg once daily either alone or in combination with metformin (Glucophage),
rosiglitazone (Avandia) or pioglitazone (Actos).
DRUG INTERACTIONS: Sitagliptin may slightly increase the concentration of
digoxin in the body when both drugs are being taken. Digoxin concentrations
should be monitored appropriately.
PREGNANCY: There are no adequate studies of sitagliptin in
pregnant women.
NURSING MOTHERS: It is unknown whether sitagliptin is secreted in human
breast milk.
SIDE EFFECTS AND PRECAUTIONS: The most common side effects of sitagliptin are
upper respiratory tract infection and headache. Sitagliptin also is associated
with abdominal pain, nausea and diarrhea. Sitagliptin did not increase the
occurrence of hypoglycemia when administered alone, with metformin or with
pioglitazone in human studies.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Managing your diabetes is important. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information is also provided in this article.
The major goal in treating diabetes is to minimize any elevation of blood
sugar (glucose) without causing abnormally low levels of blood sugar. Type 1
diabetes is treated with insulin, exercise, and a
diabetic diet. Type 2 diabetes
is treated first with weight reduction, a diabetic diet, and exercise. When
these measures fail to control the elevated blood sugars, oral medications are
used. If oral medications are still insufficient, treatment with insulin is
considered.
Adherence to a diabetic diet is an important aspect of controlling elevated
blood sugar in patients with diabetes. The American Diabetes Association (ADA)
has provided guidelines for a diabetic diet. The ADA diet is a balanced,
nutritious diet that is low in fat, cholesterol, and simple sugars. The total
daily calories are evenly divided into three meals. In the past two years, the
ADA has lifted the absolute ban on simple sugars. Small amounts of si...