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Prescribed with Istamet and Metformin for diabetes. How do these medicines work in the body?

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I have been diagnosed by diabetes. These days, I have 140-150 fasting and 220-250 after two hours of meal. I want to start medication and Doctor has recommened me to start Istamet 50mg/1000 mg (Each film coated tablet contains 64.25 mg of sitagliptin phosphate monohydrate equalivalent to 50 mg of sitagliptin and 1000 mg of metformin hydrochloride IP).
I want to understand "how it works in the body"?
Posted Mon, 21 May 2012 in Diabetes
 
 
Answered by Dr. Amit Rajput 56 minutes later
Hello XXXXXXX

Thank you for posting your query on XXXXXXX

Your blood sugars need to be within normal acceptable range to prevent complications due to high sugars in the future. Your doctor has selected a very rational combination of medicines for you.

As you rightly pointed out, Istamet is a combination of two drugs - Sitagliptin and Metformin.

Sitagliptin inhibits an enzyme called DPP4, which usually destroys a hormone called GLP1 in the body. So, more GLP1 is available in the blood which helps in adequate release of Insulin from pancreas which in turn helps lowering blood glucose.

On the other hand, Metformin decreases Insulin resistance in the body (mainly in muscles and liver). Insulin resistance is an integral part of Type 2 diabetes. Once the insulin resistance is lowered, the body responds well to its own Insulin resulting in lowering of blood glucose.

Combining both tablets is a very good regimen to control diabetes. However, you need to keep monitoring your blood glucose on regular basis as suggested by your physician.

Hope I have answered your query. I will be available to answer your follow up queries, if any.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Prescribed with Istamet and Metformin for diabetes. How do these medicines work in the body? 16 minutes later
Sitagliptin inhibits an enzyme called DPP4, which usually destroys a hormone called GLP1 in the body. So, more GLP1 is available in the blood which helps in adequate release of Insulin from pancreas which in turn helps lowering blood glucose.

Bit confusion, if DPP4 destroys GLP1, then how GLP1 will be available to help ......
 
 
Answered by Dr. Amit Rajput 40 minutes later
Hello and thanks again,

Normally in a body, GLP1 is produced by intestines just for few seconds in response to food. GLP1 acts on pancreas to produce insulin. DPP4 is the enzyme which destroys it normally.

Sitagliptin inhibits DDP4 so GLP1 stays in the blood for more duration releasing more insulin. Sitagliptin also has an additional action on alpha cells of pancreas which produce Glucagon (which has actions exactly opposite to that of Insulin).

To simplify it further - Sitagliptin has pro-insulin and anti-glucagon actions resulting in lowering of glucose.

Hope this clarifies your doubts. Let me know if I have missed out on any concerns. Please accept my answer if you do not have further queries.

Wish you Good Health.

Regards.

Above answer was peer-reviewed by
 
Follow-up: Prescribed with Istamet and Metformin for diabetes. How do these medicines work in the body? 15 hours later
Doctor, your rating for Istamet?
 
 
Answered by Dr. Amit Rajput 15 minutes later
Hello XXXXXXX

I would rate the combination of Sitagliptin and metformin (the contents of Istamet) very highly.

Hope this clarifies your doubt. Please accept my answer if you do not have further queries.

Wish you Good Health.

Regards
Above answer was peer-reviewed by
 
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