Hi Stan,

Thank you for your question. Congratulations on being controlled, and on your daily exericise. It sounds as though you are taking good care of yourself. Changing from metormin to Januvia will most likely cause you to lose your tight control over diabetes. Januvia is not as effective as metformin in controlling blood sugars, so you daily sugars, as well as your hemoglobin A1c level will likely increase. On the other hand, metformin should not be used in patients with a creatinine greater than 1.5, and should be used with caution in the elderly as you mentioned.

This is something that you need to discuss more thoroughly with your doctor. Since your diabetes is well-controlled right now, you need to weigh the risks and benefits before making any drastic changes to your regimen. If you and your doctor decide to take you off metformin, there are alternatives that can give you similar control over the disease, such as the drug class sulfonylureas (glyburide, glipizide, and glimepiride), the drug class glitazones (pioglitazone and rosiglitazone).

Best of luck,

Casey