Metformin change 3 x 850 to Januvia 25

I've been with type 2 diabetes for 10 years and taking metformin 850 morning and night.

A couple of months ago I got the dose of metformin 850, also take it at noon, for a slight climb in glucose analysis.

From then on I started having many stomach discomfort and having to go to the bathroom many times, every time something reached the large intestine I had to run to bathroom, in the analysis the glucose came out at 7.2.

I have a bit high transaminases aminotransferase = 91, normal less than 40

Discuss the problems with the doctor and change me a week Januvia 25, a 25 mg pill a day and in three months we repeat results.

The week I have disappeared all digestive problems.
But even minimizing the consumption of carbohydrates and making walks of hours, the glucose controls that I make every day, always place me about 140.

Question: Januvia 25, a single pill a day and nothing else, isn't it a very low dose?I see that in the medicine the dose is usually 100 mg day.

The only explanation I see is that I try to increase the dose very little by little, to avoid some reaction.But throwing three months with this dose, isn't it much time?

Thank you!!

Hi @berto

Metformin is a medication commonly used in the treatment of type 2 diabetes and can cause gastrointestinal side effects, such as those you mentioned.Change to Januvia (Sitagliptin) is a common option when patients have significant side effects with metformin.Januvia works differently from metformin and generally has fewer gastrointestinal side effects.

Regarding the dose of Januvia, 25 mg a day may seem low compared to the standard dose of 100 mg, but there are several reasons why your doctor could have chosen this dose.Among them:

- Individual sensitivity: Each person responds differently to medications, and some may need lower doses to obtain the same effects.

- Prevention of side effects: If you have had problems with the side effects of other medications, your doctor could be cautious, starting with a low dose and gradually increasing it if necessary.

- Interactions with other medications: if you are taking other medications, there could be interactions that justify a lower dose.

- Condition of your kidneys: Januvia is excreted through the kidneys.If you have any decrease in renal function, a lower dose may be required.

It is possible that your doctor is planning to review how you respond to this lower dose and adjust it depending on your results and how you feel.It is important to have an open communication with your doctor and discuss your concerns and observations.

Finally, diabetes management is a continuous process that implies not only medications, but also diet, exercise and regular monitoring of blood glucose.If you have additional concerns or if your glucose levels are not where you would like them to be, it is important that you discuss it with your doctor and ask other people with diabetes.

Thank you very much for the answer!