I was diagnosed in December 2007, after a yeast infection, based upon GAD testing with Type 1 diabetes. I was on very little insulin for two weeks. It brought my 329bg down to 70. I stopped taking the insulin and went for a second opinion. My AC1 was 7.2 down from 11 in November. The new doctor thinks I will most likely be Type 1, however is treating me with 100mg of Januvia daily. I exercise daily and watch the carbs in my diet. Since September of 2006 I dieted to lose about 40 pounds. Cholesterol 177, HDL76,, LDL93, Triglyceride 45. My fasting blood glucose taken in April was 118 without any medication. I tested my bg randomly and found it to be in the 113-125 range in the morning. Other times seem to be normal. The Januvia brings it down to 95-99 in the morning. I am concerned about taking the Januvia from reports about immunity.
Q: Is Januvia often prescribed for type 1 diabetes if the patient does not yet require insulin?
Hi Maryann,
Thank you for your question. Januvia is not approved for treatment in Type 1 diabetics, so I'm unsure why you would even be taking this medication to begin with. In Type 1 diabetes, the beta cells of the pancreas are destroyed and therefore cannot produce enough insulin to fulfill the body's needs. Januvia works by stimulating the beta cells and increasing the release of insulin from the pancreas, but it cannot stimulate the beta cells once they have died. You can read more about Januvia here.
If you are in fact a Type 1 diabetic, you need to discuss with your doctor why he or she has prescribed Januvia for you, and whether there is a better alternative available.
Best of luck,
Casey
Are you still on the Januvia? Are you taking any insulin?
Some stuff from something I'm writing. Januvia (a DPP-4 inhibitor which raised glucagon-like-peptide-1) and Prevacid (which raises gastrin) are being tested for attempting to regenerate beta cells, and appear to somehow reset the autoimmunity as well. Bone marrow derived stem cells have also been used to do the same, although this was a small Phase I trial, and was the cure was not complete. Hyperbaric oxygen therapy may aid islet survival, although this has been looked at only in the context of islet transplantation, not regeneration. HBOT also may mobilize the proper types of stem cells to take advantage of the effect Couri noted.
Januvia and Prevacid:
[339] “Combination Therapy With Sitagliptin and Lansoprazole to Restore Pancreatic Beta Cell Function in Recent-Onset Type 1 Diabetes (REPAIR-T1D).” NCT01155284. Phase 2, August 2010-(estimated) April 2014, at http://clinicaltrials.gov/ct2/show/NCT01155284 (accessed December 28, 2010)
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[340] Suarez-Pinzon WL et al. “Combination therapy with a dipeptidyl peptidase-4 inhibitor and a proton pump inhibitor restores normoglycaemia in non-obese diabetic mice.” Diabetologica 2009; 52(8): 1680-1682
[341] Tian L et al. “Reversal of New-Onset Diabetes through Modulating Inflammation and Stimulating β-Cell Replication in Nonobese Diabetic Mice by aDipeptidyl Peptidase IV Inhibitor.” Endocrinol. 2010; 151(7): 3049-3060
[342] Rabinovitch A. “Search for Diabetes "Cure" Focuses on Beta-Cell Regeneration.” Medscape Diab Endocrinol. 2010, at http://www.medscape.com/viewarticle/734370, accessed December 28, 2010
Couri trial of HSC therapy:
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Couri CEB et al. “C-Peptide Levels and Insulin Independence Following Autologous Nonmyeloablative Hematopoietic Stem Cell Transplantation in Newly Diagnosed Type 1 Diabetes Mellitus.” JAMA. 2009; 301(15): 1573-1579:
“A prospective phase 1/2 study [was performed] of 23 patients with type 1 DM (aged 13-31 years) [..] During a 7- to 58-month follow-up (mean 29.8), 20 patients became insulin free. 12 patients maintained this status for a mean 31 months (range 14-52) and 8 relapsed and resumed insulin use at low dose (0.1-0.3 IU/kg). [..] After a mean follow-up of 29.8 months following autologous non-myeloablative HSCT, C-peptide levels increased significantly and the majority of patients achieved insulin independence with good glycemic control.”
HBOT and islet survival:
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[118] Sakata N et al. “Hyperbaric oxygen therapy improves early posttransplant islet function.” Pediatr Diabetes. 2010
[119] Hughes SJ et al. “Hyperoxia improves the survival of intraportally transplanted syngeneic pancreatic islets.” Transplantation. 2003; 75(12): 1954-9.
[120] Juang JH et al. “Beneficial effects of hyperbaric oxygen therapy on islet transplantation.” Cell Transplant. 2002; 11(2): 95-101
[121] Juang JH. “Islet transplantation: an update.” Chang Gung Med J. 2004; 27(1): 1-15.
HBOT and stem cells:
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[62] Thom SR. “Stem cell mobilization by hyperbaric oxygen.” Am J Physiol Heart Circ Physiol. 2006; 290(4): H1378-86.
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[136] Milovanova TN et al. “Hyperbaric oxygen stimulates vasculogenic stem cell growth and differentiation in vivo.” J Appl Physiol. 2009; 106(2): 711-28
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