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Drug Information: Galvus

Galvus belongs to a newer class of Type 2 Diabetes treatment medications called the DPP4-inhibitors. The other drugs in this class include Januvia and Onglyza. This class of drugs works by releasing more insulin from the pancreas in response to food entering the stomach of a patient. This enhanced insulin release leads to more glucose uptake and therefore an overall lower level of blood sugar.

How effective is Galvus?
In order to explain the effectiveness of Galvus and to try and provide unbiased information we will look at studies conducted before Galvus came on the market.

The endpoint in measuring the effectiveness of any diabetic drug is the measurement of patients HbA1c (percentage of glucose in the Red Blood Cells--accepted healthy value is 7% or less) and the patients fasting blood glucose. Galvus will rarely be used alone, it is most commonly used in combination with Metformin(one of the oldest diabetes drugs, and is usually the physicians first choice in treating a patient). Therefore, in assessing the effectiveness of Galvus, we looked at a study when it was added in addition to Metformin. The results of this study showed that all diabetes measurements were reduced to a significant effect than when the patient was treated with Metformin alone. These measurements include Fasting Plasma Glucose (your sugar level when your stomach is empty), HbA1c (glucose in the Red Blood Cells), and Peak Prandial Glucose (the highest level of sugar).

Most importantly, these results achieved at 12 weeks were sustained over a year, indicating that patients treated with Galvus can achieve good long-term sugar control. In patients maintained on metformin alone, glycaemic control tended to deteriorate over time. This is one of the reasons that a patient will rarely be on only 1 diabetes medication.

The other important finding with Galvus treatment was that it was not associated with weight gain, which is an important benefit for patients with type 2 diabetes.

How does Galvus compare to other DPP4-inhibitor drugs?
The other drugs in the DPP4-inhibitor class include Januvia and Onglyza. From what has been studied so far with this class of drugs, there appears to be no difference between the other drugs in this class. All drugs produce similar drops in HbA1c, achieving reductions of close to 3%, in patients with the highest baseline HbA1c, in combination with other drugs and getting the majority of patients to the <7% target when used in dual therapy. All 3 drugs have similar good tolerability profiles with regard to weight-neutrality (no effects on weight gain) and freedom from hypoglycaemic episodes (falling of blood sugar) and other side effects. Small differences, said not to be clinically meaningful have emerged in trials, for example a rise in uric acid and neutrophils with Januvia.

Therefore the choice of a DPP4-inhibitor drug will ultimately be the choice of the patients physician.

What is an advantage of Galvus compared to other diabetic meds?
One of the most interesting findings when studying Galvus is that when it is used in combination with other diabetes medications, it actually reduced the potential side-effects of the other diabetes medications. For example, when combined with the TZD class of meds (ex. Avandia), it reduced the chance of peripheral edema(swelling in extremities), and when combined with metformin, it reduced the chance of GI (stomach) upset.

The other finding was the excellent level of effectiveness in older patients (>65yrs). There was an average HbA1c level of 6.2% - a level approaching normal (non-diabetic) in over 65s treated with Galvus and pioglitazone (Avandia). When Galvus was added to metformin, there was observed a significantly reduced incidence of GI side effects and a further reduction in HbA1c of 1.3% among older patients.

What side effects can I see with Galvus?
The most common side effects you can potentially see with Galvus are tremor, headache, dizziness, or nausea. These will usually be mild and will probably pass with time. For example, you may experience a slight headache after taking your first dose of Galvus, however, this usually subsides and won’t occur with the second dose.

No medication is free of side-effects; HOWEVER, Galvus presents a definite advantage over other diabetes medications in that it has no weight gain and will not cause peripheral edema (swelling-retention of water, leading to swelling of ankles, etc) unlike other commonly used diabetes medications.

Where can I get more information on Galvus?
Galvus prescribed patients, who try to place an order for Galvus from an online pharmacy store, can place their prescription order at the CanadaDrugsOnline.com which is an online Canadian pharmacy store.