Having Kidney Disorder And Diabetes, Taking Januvia, Ace-inhibitor And Metformin. Have Goitre. Right Medication?
You have diabetes with early kidney disease and goiter.
Your kidney disease is not so bad. In-fact you can continue ACE-Inhibitors and metformin.
Kidney friendly diabetes medicines would include-- glimiperide, gliclazide, metformin can be used till 1.5 mg/dl serum creatinine levels. Januvia is actually pretty safe for the kidneys. Some trials have shown it to be drug of choice in post renal transplant patients.
Goitre is not a common side effect of januvia, though you can discuss with endocrinologist regarding the same.
Being on ACE-I you should monitor your Serum creatinine and potassium levels every month initially for 3 months and then 2 monthly- just to keep an eye on kidney functions. If they deteriorate then consider stopping ACE-I under guidance of your doctor.
Once GFR falls below 25 ml/min, insulin is best for sugar control.
Hope this answers your queries,
If any more questions please write-in.
Best wishes.
or would prandin be a better drug I also take levimer
Nateglinide and Prandin (Ripaglinide) both are safe for kidney patients and are same group drugs. These are short acting medicines and role is in postprandial sugar control only. They do not have a longer effect to control fasting sugars. They are insufficient if the fasting sugars are high. they can be combined with other medications. Januvia on the other had has slightly more effect on fasting sugars as well.
Levemir is a long acting insulin and mainly used to control fasting premeal sugars.
So a combination of Levemir with januvia or with prandin is quite a good way to control sugars.
The best way is let your doctor start with any one treatment combination. Monitor your sugars with glucometer and fine tune the drug doses to achieve good control. All these medicines are safe for the kidneys.
Hope this helps,
Bye
dly is it
Nateglinide metabolite, N-[trans-4-(1-hydroxy-1methylethyl)-cyclohexanecarbonyl]-D-phenylalanine levels can remain elevated in advanced renal failure patients. but in early kidney disease like your they are completely safe if used under guidance of doctor. It is also safe with levemir .
hope this clarifies the issue.