Okay so after a year or so on competact (competact tablets contain two active ingredients, metformin hydrochloride and pioglitazone hydrochloride) my lovely Diabetes Nurse Sarah has agreed to change my meds. Her suggestion is to keep with the Metformin, but to add a different active ingredient, VILDAGLIPTIN. At my request the metformin is being upped to 1g from 800mg – everything i read suggests that my blood sugars should be as low as practical, and I am hovering around the 6 mark. Hopefully the extra 0.4g per day will help. The pioglitazone also may be contributing to my weight gain – 15kg since Christmas, and hopefully the vildagliptin will be more weight neutral. Watch This Space! I have put some info on vildagliptin below for anyone remotely interested.

Note the trade name for the combined metformin and vildagliptin is Eucreas

Galvus (vildagliptin)

Main use Active ingredient Manufacturer

Type 2 diabetes Vildagliptin Novartis

How does it work?

Galvus tablets contain the active ingredient vildagliptin, which is a type of medicine called a dipeptidyl peptidase-4 (DPP-4) inhibitor. It is used to treat type 2 or non-insulin dependent diabetes (NIDDM).

Vildagliptin works by increasing the amount of two incretin hormones found in the body, called glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). These hormones are normally produced naturally by the body in response to food intake. Their function is to help control blood sugar (glucose) levels.

GLP-1 and GIP have two main actions that help to control blood glucose.

Firstly, they stimulate the pancreas to produce insulin in response to increasing levels of glucose in the blood. (Insulin is the main hormone responsible for controlling sugar levels in the blood. It causes cells in the body to remove sugar from the blood.)

GLP-1 also reduces the production of glucagon. (Glucagon is a hormone that normally increases glucose production by the liver.)

GLP-1 and GIP are normally broken down by an enzyme in the body called dipeptidyl peptidase-4 (DPP-4). Vildagliptin works by binding to this enzyme and preventing it from breaking down the GLP-1 and GIP. This increases the levels of these hormones in the body and so increases their effect on controlling blood sugar.

What is it used for?

* Type 2 diabetes (non-insulin dependent diabetes).

Galvus is used for people with type 2 diabetes whose blood sugar is not sufficiently controlled by other antidiabetic medicines. It can be added to treatment with metformin; a sulphonylurea, for example gliclazide; or another type of antidiabetic medicine known as a thiazolidinedione, for example pioglitazone or rosiglitazone.

Warning!

* Hypoglycaemia (low blood glucose) has been commonly reported when this medicine is used in combination with metformin or sulphonylurea medicines, eg glimepiride. Symptoms of hypoglycaemia usually occur suddenly and may include cold sweats, cool pale skin, tremor, anxious feeling, unusual tiredness or weakness, confusion, difficulty in concentration, excessive hunger, temporary vision changes, headache, nausea and palpitations. You should talk to your doctor or diabetes specialist about this and make sure you know what to do if you experience these symptoms.

* Your ability to concentrate or react may be reduced if you have low blood sugar, and this can cause problems driving or operating machinery. You should take precautions to avoid low blood sugar when driving - discuss this with your doctor. This medicine may also cause dizziness or fatigue. If affected you should take care driving or operating machinery.

* People with diabetes have a higher risk of developing foot ulcers and blistering of the skin. It is therefore important to have a good foot care routine. Consult your doctor if you get any new blisters or ulcers while taking this medicine.

* Rare cases of inflammation of the liver (hepatitis) have been reported in people taking this medicine. For this reason, your liver function should be checked before starting treatment, every three months during the first year of treatment, and regularly thereafter. You should consult your doctor if you develop any of the following symptoms while taking this medicine, so that your liver can be checked: unexplained nausea, vomiting, abdominal pain, fatigue, loss of appetite, darkened urine or yellowing of the eyes or skin (jaundice).