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Shedding Light on the Co-morbidities of DiabetesThe Complications of Having Rheumatoid Arthritis and Diabetes

Dr.advised switching from metaformin to janovia. Age 81. ???

STAN
06/14/08

Have been using metaformin for 10 years with very good control . Exercise daily. I understand metaformin is not suggested for use after age 80-but I also know metaformin is reliable with minimal adverse side effects. Creatine level slightly high (1.6)but does increase with age. Weighing possible (if any) risks vs large cost increase.

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Answers (1)
Casey McNulty
Tuesday, June 17, 2008

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

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