( ratelyincreased overall post-meal a...)An Investigational Study Released at ADA Showed that Initial,Combination Therapy with Januvia (sitagliptin) and Metformin Led to,Improvement in Markers of Beta Cell Function in Patients with Type,2 Diabetes,Health

rately, increased overall, post-meal, active concentrations of GLP-1 levels by 1.95- and 1.76-fold, respectively (pless than0.001), compared with placebo. When administered together, JANUVIA and metformin increased active concentrations of GLP-1 by 4.12-fold (pless than0.001) compared with placebo. In contrast to active GLP-1 levels that were increased by both drugs, the levels of total GLP-1 (which includes both active and inactive GLP-1) were increased by metformin only and not by JANUVIA. These observations are consistent with the effect of JANUVIA to raise active GLP-1 levels by reducing the clearance, but suggest that metformin acts in a different manner to increase active GLP-1 levels. This study provides evidence that the two drugs may have complementary effects on GLP-1.

"This is the first study in humans that showed that metformin increases the concentration of the incretin hormone, GLP-1; thus increasing the total GLP-1 available. When used together with JANUVIA, a DPP-4 inhibitor that blocks the degradation of GLP-1 by inhibiting its breakdown, there was an increase in GLP-1 levels greater than what either agent provided alone," said Nir Barzilai, M.D., professor of Medicine and Molecular Genetics and director of the Institute for Aging Research, Albert Einstein College of Medicine. "It appears as though metformin allows for more total GLP-1 to be available, and JANUVIA helps GLP-1 to remain active thus acting in a complementary way."

GLP-1 plays an important role in regulating the body's blood sugar levels. When food is consumed, GLP-1 is released by the gastrointestinal tract to stimulate the pancreatic beta cells to secrete insulin, a hormone that helps the body to use glucose for energy. GLP-1 also suppresses the release of glucagon from the pancreatic alpha cells, which, in turn, tells the liver to reduce its production of sugar.

Dosing of JANUVIA

The recommended dose of JANUVIA is 100 mg once daily, with or without food,
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