Trajenta’s (Linagliptin) reduces the synthesis of the hormone glucagon and increases insulin production. As a result, this class of medications is now recognized as one of the most promising for controlling the dangerous ailment – of type 2 diabetes.
What Is Diabetes Mellitus?
Diabetes mellitus is a broad term for a number of illnesses connected with metabolic problems, specifically a carbohydrate metabolism. The disease comes in two main forms: insulin-dependent, where the main issue is that the body cannot secrete enough hormone to maintain a healthy level of metabolism, and insulin-resistant, where there is insulin in the body, but its function is impaired, and the tissues only partially respond to hormone signals. Pregnancy-related diabetes, commonly referred to as gestational diabetes, is found in expecting mothers during the middle of their pregnancy and is associated with the process of carrying the fetus.
90% of people with diabetes have type 2, making it the most prevalent form of the condition. Insulin resistance is often observed when the body doesn’t fully react to the production of enough hormones. Plasma glucose levels keep increasing, causing more insulin to be released since it is unable to function at its full potential. The hormone and glucose issues in some type 2 diabetic people may eventually deplete pancreatic reserves. Due to the depletion, the body generates less and less insulin, which raises blood sugar levels even more (hyperglycemia).
Older persons are frequently diagnosed with type 2 diabetes. Nevertheless, during the last 20 to 30 years, it has become more and more common among school-aged children, teenagers, or young adults due to rising rates of obesity, a lack of physical exercise, and a poor diet (high in calories and fat).
A nutritious diet, increased physical activity, and keeping a healthy body weight are the cornerstones of controlling type 2 diabetes. To regulate blood glucose levels, doctors frequently recommend oral medicines (also known as blood glucose-lowering therapies) and/or injectable insulin. However, selecting the best diabetic drugs at once is very challenging; instead, it is crucial to identify all the concomitant pathologies as well as effective treatments.
It has come to the first place among the causes of mortality in the last two decades. The main provocative factor in the development of the disease is considered a failure of the immune system. As a result, the body produces antibodies that have a damaging effect on pancreatic cells. As a result, large amounts of glucose circulate freely in the blood, hurting organs and systems. Furthermore, due to the imbalance, the body uses fats as an energy source, leading to the increased formation of ketone bodies, which are toxic substances. Consequently, all kinds of metabolic processes occurring in the body are disturbed.
|NAME OF DRUG||CLASSIFICATION||INDICATION||MECHANISM OF ACTION||CONTRAINDICATION||SIDE EFFECTS||ADVERSE EFFECTS||NURSING RESPONSIBILITIES|
|Adjunct to diet and exercise to improve glycemic control
in adults with type 2 diabetes as monotherapy or as combination therapy
with an insulin secretagogue (such as sulfonylurea) or insulin.
|Inhibits DPP-4, an enzyme that rapidly inactivates incretin hormones,
which play a part in the body’s regulation of glucose.
|Drug not for use in patients with type 1 diabetes
or for treatment of diabetic ketoacidosis.
|> sore throat
> stuffy nose
> Observe the 25 rights in drug administration.
> Assess vital signs.
> Assess for other complication.
> Monitor HbA1c and fasting blood glucose levels periodically.
Therefore, when the disease is detected, it is especially important to choose the right therapy and use quality drugs, such as Trajenta medicine, reviews on which doctors and patients can find below. The danger of diabetes is that it may not give clinical signs for a long period, and the detection of high sugar levels is indicated accidentally during the next preventive checkup.
The Consequences of Diabetes Mellitus
Scientists worldwide are constantly researching to identify new formulas to create a drug that can defeat the terrible disease. In 2012, a unique drug was registered in our country, which causes almost no Trajenta side effects and is perfectly tolerated by patients. In addition, it is allowed to be taken by individuals with renal and hepatic failure – it is written so in the reviews about linagliptin.
The following complications of diabetes mellitus pose a danger:
- reduction in visual acuity up to its complete loss;
- kidney malfunction;
- vascular and heart disease – myocardial infarction, atherosclerosis, chd;
- foot diseases – purulent-necrotic processes, ulcerous lesions;
- the appearance of blemishes on the dermis;
- skin lesions with fungus;
- neuropathy, which is shown by cramps, peeling, and decreased sensitivity of the skin;
- an impaired function of the lower extremities.
So why is it reasonable for many patients to use a combination drug containing antidiabetic components of different classes? The fact is that, unfortunately, type II diabetes mellitus is often indicated quite late. The gradual development of the disease can explain this – symptoms may initially be absent or mild due to the adaptation of patients to long-term hyperglycemia.
Sometimes only compliance with dietary recommendations and using oral antidiabetic agents of different pharmacotherapeutic groups in monotherapy does not allow for adequate glycemic control.
Therefore, many patients initially require therapy that includes several antidiabetic drugs, as only this approach allows them to provide an optimal level of blood glucose control.
It is proved by the data of a large-scale UKPDS (UK Prospective Diabetes Study), conducted from 1977 to 1997, which included 4075 patients. The study showed that after 3 years of monotherapy, the target level of glycemic control (fasting blood glucose concentration of 7.8 mmol/l and glycosylated hemoglobin less than 7%) was noted in only half of the patients, and after 9 years – only 25% of patients. Thus, for long-term adequate glycemic control, most patients need the prescription of combined treatment.
Tablets for the Type II Diabetes Mellitus Treatment
Type II diabetes is based on both insulin resistance and impaired insulin secretion. Type II diabetes (primarily insulin resistance) is a part of the so-called metabolic syndrome, which is visceral obesity, dyslipidemia, and arterial hypertension. Metabolic syndrome and type II diabetes, as one of its manifestations, are the leading causes of death in the developed countries of Europe and North America. Moreover, in the 1990s, the mortality rate from type II diabetes mellitus was steadily increasing.
One of the peculiarities of type II DM is its long, low-symptomatic course. In the early stages of the disease, hyperglycemia promotes both the development of marked impairment of insulin secretion and the rapid progression of atherosclerosis and damage to the nervous system. The absence of clinical symptoms of a moderate (up to 7-10 mmol/L and above) increase in glycemia leads to a low turnout of patients in medical institutions and creates the illusion of apparent well-being. All this leads to the fact that at the time of indication of type II DM (usually accidental), patients already have disease complications in the form of visual signs (retinopathy) and renal and vascular lesions of the heart, brain, and lower extremities. The above complications are the leading cause of death and high disability in patients with type II DM.
Currently, the pathogenesis of type 2 DM complications has been defined in international multicenter prospective clinical studies (DECODE, UKPDS, Helsinki Policemen Study, Kumamoto Study, etc.) and laboratory models. The development of DM complications is based on insulin resistance, compensatory hyperinsulinemia, and hyperglycemia, primarily developing after meals.
The development of type II diabetes undergoes a series of successive stages, culminating in a persistent decrease in insulin secretion (Fig.). Therefore, one of the main goals of type II DM therapy is to maintain normoglycemia and preserve the reserve capacity of beta-cells of the pancreas. Since carbohydrate metabolism disorders are not the only manifestations of DM, and hyperglycemia and insulin resistance lead to disorders of all types of metabolism, compensation of DM is carried out in several directions.
The primary and most important task of treating type II DM is normalizing glycemia. The largest prospective clinical study UKPDS (the United Kingdom Prospective Diabetes Study) convincingly showed that normalization of glycemia prevents or delays the development of all complications of type II DM. A decrease in HbA1c level by 1% leads to a decrease in overall mortality by 21, cardiovascular morbidity by 14, and microcirculatory disorders by 37%. At the same time, the risk of death in type II DM is reduced by 42% and 63%, while HbA1c is reduced by 2% and 3%, respectively.
Another major study, DECODE (Diabetes Epidemiology: Collaborative Analysis of Diagnostic Criteria in Europe), showed that the presence of glycemia after a meal at 11 mol/L (10.0 mmol/L in whole venous blood) increases the risk of cardiovascular mortality by 2 or more times regardless of the level of glycemia on an empty stomach. Today, the physician’s arsenal has all the possibilities to influence the mechanisms of hyperglycemia development in type II DM.
Nutrition and physical activity are important components in treatment. The role of diet and increased physical activity have proven effective in preventing type II DM. According to the DPP (Diabetes Prevention Program), active lifestyle changes in individuals with impaired glucose tolerance (NTG) resulted in a 58% reduction in the development of type II DM. At the same time, in the later stages of type II DM, lifestyle modification does not lead to the complete elimination of hyperglycemia.
For example, in the UKPDS mentioned above, only 6% of patients on diet therapy achieved acceptable HbA1c values (7%) over an 8-year follow-up period. Moreover, the epidemiological, clinical, and laboratory observations available today, show that achieving glycemic targets in type II DM should begin as soon as possible after type II DM is indicated. In the vast majority of cases, this requires drug therapy.
All antidiabetic therapy for type II DM can be divided into four groups:
- Drugs with a pronounced effect on eliminating insulin resistance (metformin, thiazolidinediones, and glitazones).
- Drugs that mainly have a direct effect on prostate beta cells, which leads to increased insulin secretion. Drugs in this group are usually used to normalize glucose levels after a meal.
- Drugs that reduce the flow of carbohydrates from the intestine into the blood (acarbose, guar gum, and partly metformin). Drugs in this group affect glycemia after meals but, unlike secretagogues, do not cause an increase in insulin secretion.
- Insulin and insulin-like drugs (analogs).
Trajenta: Description, Composition
The medicine is available in tablet form. Round, biconvex tablets with beveled edges have a light red coating. On one side, there is a manufacturer’s symbol in the form of engraving. On the other side, there is an alphanumeric designation D5.
The active ingredient is linagliptin. Due to its high efficacy, five milligrams are sufficient for a single linagliptin dose. This component reduces the synthesis of glucagon by increasing the production of insulin. The effect comes one hundred and twenty minutes after taking it – this is the time after which the maximum concentration of it in the blood is observed. Excipients necessary for the formation of the tablet:
- Magnesium stearate;
- Pregelatinized and corn starch;
- Mannitol – diuretic.
Uses of Trajenta
According to reviews and instructions for use, Trajenta is recommended for treating type 2 diabetes mellitus both in monotherapy and in combination with other sugar-lowering tablets, as well as insulin drugs. In the first case, it is prescribed when:
- there are contraindications to taking metformin or kidney damage;
- inadequate control of glycemia despite exercise and a special diet;
- ineffectiveness of monotherapy with the medications and with the help of diet and exercise is shown by complex treatment;
- with sulfonylurea derivatives, metformin, thiazolidinedione;
- with insulin or metformin, pioglitazone, sulfonylurea derivatives, and insulin;
- with metformin and sulfonylurea derivatives.
Trajenta Mechanism of Action and Contraindications
According to reviews and instructions, Trajenta drug class is not allowed to be taken while waiting for a baby, as well as during breast feeding. In preclinical studies, it was found that the active ingredient (linagliptin) and its metabolites get into breast milk. Therefore, negative effects on the fetus and breastfed babies cannot be excluded. If it is impossible to cancel the drug and replace it with a similar one, doctors insist on switching from natural to bottle-feeding.
Taking the tablets is also contraindicated in the following conditions:
- age under eighteen years;
- diabetic ketoacidosis;
- diabetes mellitus type 1;
- individual intolerance to the ingredients of Trajenta.
In the medical reviews, as well as in the instructions for use of this drug, there is information that it should be used with caution by persons over eighty years of age if it is taken simultaneously with insulin and (or) sulfonylurea-based drugs. Studies on the drug’s effect on the ability to drive machinery and transport vehicles have not been conducted. However, use id with caution due to the possible occurrence of hypoglycemia, especially when receiving combined therapy. If acute pancreatitis is detected, the drug should be discontinued. In this case, the doctor will choose a different therapy.
It is important to remember that for the treatment of ketoacidosis of type 1 diabetes, it is forbidden to take Trajenta. In addition, it is noted that the risk of cardiovascular abnormalities does not increase. Individuals who have a failure of liver and kidney function can safely take the drug in the usual dose, its adjustment is not required.
In the age category of seventy to eighty years, the use of linagliptin showed good results. A significant decrease was observed:
- glycosylated hemoglobin;
- plasma sugar levels on an empty stomach.
Administration of the drug by people over eighty years old should be performed with special caution because the clinical experience of use in this group is minimal.
The incidence of hypoglycemia is minimal when taking Trajenta alone. Patient reviews also confirm this fact. In addition, in their comments, they note that even in combination with other diabetes medications, the development of glycemia is negligible. In these cases, if necessary, the doctor can reduce the linagliptin dosage of insulin or sulfonylurea derivatives. Taking Trajenta does not increase the risk of heart attack or stroke, which is important when taken at an older age.
Many medications used to treat diabetes mellitus can lead to a pathological condition in which blood glucose levels drop dramatically, posing a danger to the patient. Trajenta, whose reviews say that taking it does not cause hypoglycemia, is an exception to the rule. This is considered an important advantage over other classes of blood glucose-lowering drugs. The adverse reactions that may occur during therapy with Trajenta are the following:
- coughing fits;
- an increase in plasma amylase;
- rash and others.
The standard measures to remove unabsorbed drugs from the gastrointestinal tract and symptomatic treatment are indicated in case of overdose.
Patients with Renal Insufficiency
“Excellent highly effective medication” – with such words usually begin enthusiastic reviews about Trajenta medication. Patients with renal failure, especially those undergoing hemodialysis, have always had serious concerns when taking antidiabetic drugs. However, with the advent of this drug in the pharmacy network, patients with kidney pathologies appreciated it, despite its high cost.
Thanks to the unique pharmacological action, glucose values are significantly reduced when taking the drug only once a day at a therapeutic dose of five milligrams. And it does not matter when to take the pills. The drug is quickly absorbed after penetration into the gastrointestinal tract; the maximum concentration is observed one and a half or two hours after intake. It is excreted with feces, i.e., the kidneys and liver are not involved in this process.
About the Drug Manufacturers
Two pharmaceutical companies carry out the production of Trajenta tablets, which are available.
- “Eli Lilly” – for 85 years it has been among the world leaders in innovative solutions to support patients diagnosed with diabetes. The company is constantly expanding its product range using the latest research findings.
- Boehringer Ingelheim – its history dates back to 1885. It is engaged in the research, development, production, and sale of medicines. This company is one of the twenty world leaders in pharmaceuticals.
At the beginning of 2011, the two companies signed a cooperation agreement in the fight against diabetes, thanks to which significant progress has been made in treating the insidious disease. The goal of the collaboration is to investigate a new combination of four chemicals included in drugs designed to eliminate the signs of the disease.
Reviews left by patients taking this medication are mostly positive. However, due to hypersensitivity or intolerance, doctors recommend similar remedies for some patients. These include:
- Sitagliptin – patients take this remedy as an addition to physical exercise and diet to improve control of the glycemic state; in addition, the drug is actively used in combination therapy;
- Alogliptin, Vipidia – most often, this medication is recommended in the absence of the effect of a diet, exercise, and monotherapy;
- Saxagliptin – produced for the treatment of type 2 diabetes, is used both in monotherapy and with other tableted medications, as well as inulins.
Selection of an analog is carried out only by your endocrinologist; changing the drug without consulting your doctor is prohibited.
According to reviews of diabetic people, Trajenta can be taken at any convenient time regardless of diet and only once a day, which is considered a huge benefit. The only thing to remember: you can’t take a double dose on the same day. When combined with therapy, the dosage of Trajenta does not change. In addition, it does not need to be adjusted for kidney problems. The pills are well tolerated, and adverse reactions are quite rare. Trajenta, reviews of which are exceptionally enthusiastic, contains a unique active ingredient with high efficacy. Another important fact is that the medicine is included in the list of drugs dropped in pharmacies on free prescriptions.
Glycemic Parameters in Placebo-Controlled Study for TRAJENTA
in Combination with Sulfonylurea*
|TRAJENTA 5 mg + SU||Placebo + SU|
|Number of patients||n = 158||n = 82|
|Change from baseline (adjusted mean***)||-0.5||-0.1|
|Difference from placebo + SU (adjusted mean) (95% Cl)||-0.5 (-0.7, -0.2)||—|
|Patients [n (%)] achieving A1C <7%**||23 (14.7)||3 (3.7)|
|Number of patients||n = 155||n = 78|
|Change from baseline (adjusted mean***)||-8||-2|
|Difference from placebo + SU (adjusted mean) (95% Cl)||-6 (-17, 4)||—|
|SU = sulfonylurea
*Full analysis population using last observation on study
**TRAJENTA 5 mg + SU, n=156; Placebo + SU, n=82
***HbAlc: ANCOVA model included treatment and number of prior OADs as class-effects, as well as baseline HbAlc as continuous covariates. FPG: ANCOVA model included treatment and number of prior OADs as class-effects, as well as baseline HbAlc and baseline FPG as continuous covariates
Trajenta Generic: Reviews of Diabetic People and Medical Practitioners
The high effectiveness of the drug has been repeatedly confirmed by medical practice and international studies. Endocrinologists, in their comments, recommend its use in the combined treatment or as first-line therapy. If a person is prone to hypoglycemia, which is provoked by improper diet and exercise, it is advisable to prescribe Tragenta instead of sulfonylurea derivatives.
It is not always possible to assess the drug’s effectiveness if it is taken in complex therapy, but in general, the result is positive, as noted by patients. In addition, there are reviews about the drug Trajenta, which was recommended for obesity and insulin resistance.
Trajenta’s cost is around $150 for a supply of 30 tablets.
The advantage of these anti-diabetic tablets is that they do not contribute to weight gain, do not provoke the development of hypoglycemia, and do not exacerbate kidney problems. In addition, Trajenta has increased safety, which is especially important for diabetic people. That is why there is a fairly large number of positive reviews about this unique remedy. However, among the disadvantages the high cost and individual intolerance should be mentioned.
Frequently Asked Questions
Is Trajenta The Same As Metformin?
Trajenta is good complementary medicine for controlling blood sugar levels but may cause body pain. It lowers blood sugar levels. Metformin is the drug of the first choice for controlling blood sugar and reducing the risk of death from diabetes, although some people may not tolerate the adverse reaction from the side of stomach.
What Is Trajenta Used For?
Trajenta’s pharmacological action is to reduce the synthesis of the hormone glucagon, as well as to increase insulin production.
How Long Does It Take For Trajenta To Work?
Depending on the dose, the medication begins to work within 4-5 days.
Is Trajenta Bad For Kidneys?
No, Trajenta is not known to cause kidney-related side effects.