Patient was educated on Janumet and its mechanism of action as follows:
- Janumet is an oral antidiabetic drug, that is a combination of Metformin and Sitagliptin, used especially in patients with type-2 diabetes.
- Janumet controls the blood sugars by the following mechanisms:
- Decreasing gluconeogenesis – Gluconeogenesis is a process that occurs in the human body in which glucose is made from sources other than carbohydrates, such as, proteins and fats. Gluconeogenesis results in increased blood sugar levels. Janumet inhibits gluconeogenesis in the liver, thereby, contributing towards reduced blood sugar. Janumet also helps in reducing absorption of glucose in the intestines, thus contributing towards reduced blood sugar.
- Janumet also helps with increasing the sensitivity of skeletal muscle for insulin. When the sensitivity for insulin increases, this results in increased glucose uptake by skeletal muscle. When more glucose is taken up by the muscle, this reduces the blood glucose. Since Janumet improves the sensitivity of muscle cells for insulin, it is used especially in individuals with insulin resistance, type 2 diabetes.
- Janumet also inhibits the enzyme dipeptidyl peptidase 4 and allows the incretins to be active for longer period. Incretins active for longer time will contribute towards increased insulin secretion, which increases the tissue uptake of glucose and reduces the blood sugar.
- By reducing the blood sugars, Janumet will reduce the need for insulin secretion from the Beta-cells of islets of pancreas.
- Control of blood sugars over time with Janumet also results in lowering of hemoglobin A1c, which is an indicator of blood glucose control over the past 2 to 3 months.
