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Done creatinine blood test result was high, advised to stop Metformin. Also on Januvia. Suggest?

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General & Family Physician
Practicing since : 2006
Answered : 3527 Questions
My creatinine bloodtest result was 1.6 H - reference range is .70 - 1.18. My Dr. wanrts to discontinue my Glyburide/Metformin which has lowered my A1C to 6.5. I would rather he discontinue my Januvia, which did not help lower my A1C and which has been associated with pancreatic cancer. What do you recommend and is there any other way to lower my creatinine level
Posted Wed, 9 Oct 2013 in Men's Health
Answered by Dr. Albana Sejdini 1 hour later
Brief Answer:
Find the real cause to high creatinine level first

Detailed Answer:

First of all, to evaluate if the creatinine level is worrisome, I should have other lab results to see your complete profile of blood count, liver and kidney function, urine analysis, etc.

It is a wise choice of your doctor advising to stop using Glyburide/Metformin and Januvia. However, I want you to check out if the pancreatic cancer is also a factor in having such low A1C.

In addition, what is the next step your doctor advised regarding treatment of pancreas cancer: surgery or drug?

As you may see, there are many other medical data to evaluate in order to take proper action in lowering creatinine level as it is very important to understand and discover what has really caused this high level.

Once the culprit is determined, proper action can be taken, which are very difficult to explain all of them here.

Waiting for the lab results to be in, you can scan them and send a copy to me for further evaluation.

Thank you!
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Follow-up: Done creatinine blood test result was high, advised to stop Metformin. Also on Januvia. Suggest? 5 hours later
Dr did not discontinue Januvia all other test were normal or low urine chemistry results were
creatinine u 49.5
micalb/crrtolur 6
microalb rndur 3

I do not have pancreatic cancer nor do I want it. That is why I am concerned with the janauvia. My dr. doesnt answer my question other than to blame it on the diabetes That is why I am concerned
I am thinking of looking for new dr.
Answered by Dr. Albana Sejdini 9 hours later
Brief Answer:
Follow the answer below

Detailed Answer:

Thank you for sending in more of your clinical data.

I also apologize for misunderstanding of "pancreatic cancer".

I understand your concern. However, keep in mind that all drugs have their own side effects. Although the medical team is explaining to you the most common and the rare effects, however, there are many other side effects that could happen to specific individuals.

It is also true that when diabetes is being uncontrolled (i.e. various oscillations in blood glucose or persistent high blood sugar level); the first organs to suffer are the kidneys.

In your case, they are starting to suffer such consequences. To my point of view, although your creatinine level is slightly high, however, it is not to be depressed.

Usually, kidney infection or urine alkalizer salts, and drinking lots of fluids (preferably water).

In addition, as your HbA1C is within the normal range, following a healthy diet, walking for at least 30 minutes a day (light exercise according to your age), taking some herbal mixture to lower blood sugar and ease other problems is one option.

Perhaps your doctor will take Januvia off in another moment. Now, I want you to understand that your body is used with above drugs. The first moment you are taking off Metformin/glyburide. In another second moment, januvia will be off and will see if you would need Metformin alone or just the above mentioned lifestyle and dietary changes.

At your age, doctors must think many times before deciding for something.

With regards to your creatinine level, I would recommend to watch your diet (do not eat too much meat). Sometimes, a person can live long and without having problems with such slightly elevated creatinine or in other times, creatinine can go back to normal once the blood sugar is stabilized (you will see the results in the next check up).

At last, before going for creatinine test, follow the below :

- do not go for heavy exercises a couple of days before the test is done

- do not eat meat (I usually recommend at all) a day (24 hours) before the test

- drink plenty of water

- avoid drinking coffee or tea within 24 hours

If you are not happy with one doctor, it is your decision to change doctor. However, it is good to have one personal doctor as he/she knows better your medical history and it is much easier for him/her to help you when needed.

Hoping this replied your inquires! Feel free to ask any other concern you might have!

All the best!
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