HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Does Januvia For Type 2 Diabetes Cause Pancreatic Cancer?

default
Posted on Mon, 23 Feb 2015
Question: I had my gallbladder removed 10 years ago and was diagnosed with type 2 diabetes 10 months ago. I am taking Januvia, metformin and a shot at night of 26cc of Lantus Solostar insulin glargine (rDNA) origin injection I am concerned that Januvia could cause pancreatic cancer. What could I take instead? My blood sugar runs 100 to 125 now. I have lost 40 lbs and went from 260 to 220. I need to protect my pancreas as much as possible. I also read that Januvia has a glucose stabilizer in it which prevents blood glucose from spiking lower. Does that explain why I can't get my glucose readings under 100????? I would like my glucose at 60 to 70 and I believe Januvia may be actually stopping me from achieving that. Which drugs would you recommend that are not incretinmimetics?
doctor
Answered by Dr. Shehzad Topiwala (4 hours later)
Brief Answer:
Diabetes

Detailed Answer:
There is no concrete proof that januvia causes pancreatic cancer. Further it is not scientifically possible that januvia is preventing your glucose from coming below 100. I understand what you are trying to say though and it sounds like a logical conclusion from what you have been told about januvia. However I wish to clarify that the real meaning of that is that it cannot cause low glucose reactions in and of itself. And regarding your question about alternative medications for diabetes, there are several such classes. Examples include SGLT2 inhibitors, Alpha glucosidase inhibitors, thiazolidenediones and bile acid sequestrants to name a few. Check with your endocrinologist if you are a candidate for some of these and especially those in the sulfonylurea and meglitinide categories
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Shehzad Topiwala (19 minutes later)
I don't have an endocrinologist, just a family practitioner. With my gallbladder out, which diabetic medicine (a brand name) would you prescribe that protects my pancreas the most? Can I just have additional metformin? The only other medicine I take is losartin for blood pressure and my blood pressure is perfect now.
doctor
Answered by Dr. Shehzad Topiwala (5 hours later)
Brief Answer:
Follow up

Detailed Answer:
When I see someone like you in my practice, I typically optimize the dose of metformin to at least 2 grams total in two divided doses, provided there is no medical condition that precludes the use of metformin, such as kidney/lung/liver or heart failure. The other circumstance is where an individual has been unable to tolerate higher doses of metformin due to gut related side effects like diarrhea.

So far no diabetes medication has been proven to protect the pancreas in humans, in the context of what you are saying.
But yes, no family of medications other than incretin mimetics have been shown to have purported associations with pancreatic cancer
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Shehzad Topiwala (44 hours later)
Could the new diabetes medicine be right for me called INVOCANA. An acquaintance said she is thrilled with it. Thanks for your previous responses.
doctor
Answered by Dr. Shehzad Topiwala (19 hours later)
Brief Answer:
Second follow up

Detailed Answer:
Yes , the SGLT2 inhibitors class of medications I was referring to includes Invokana. There are couple other medicines in this category available in USA.
Check with your endocrinologist if this is a suitable option for you. (S)he will discuss the risks and benefits with you and then you can make an informed decision if this medication is something you wish to try.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Shehzad Topiwala (1 hour later)
To be clear Invokana is or is not in the incretin mimetic category?
doctor
Answered by Dr. Shehzad Topiwala (11 hours later)
Brief Answer:
Third follow up

Detailed Answer:
No. Incretin mimetics include 2 categories of medications. One is DPP4 inhibitors and the other is GLP1 analogues.
Invokana belongs to a different class of medicines called SGLT2 inhibitors
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Does Januvia For Type 2 Diabetes Cause Pancreatic Cancer?

Brief Answer: Diabetes Detailed Answer: There is no concrete proof that januvia causes pancreatic cancer. Further it is not scientifically possible that januvia is preventing your glucose from coming below 100. I understand what you are trying to say though and it sounds like a logical conclusion from what you have been told about januvia. However I wish to clarify that the real meaning of that is that it cannot cause low glucose reactions in and of itself. And regarding your question about alternative medications for diabetes, there are several such classes. Examples include SGLT2 inhibitors, Alpha glucosidase inhibitors, thiazolidenediones and bile acid sequestrants to name a few. Check with your endocrinologist if you are a candidate for some of these and especially those in the sulfonylurea and meglitinide categories