“My husband feels very hungry with his diabetic medication. What should I do?”

Many diabetes medications stimulate the appetite and promote weight gain and this may prove counterproductive in the management of the problem. In this situation a change to a medication such as a GLP-1 analogue (Victoza, Trulicity, Byetta, Ozempic) which curbs appetite while reducing blood glucose, may be considered. I prefer to introduce an appetite suppressant such as phentermine, early in the course of management for obese patients with diabetes, knowing that weight loss will solve many of their problems.

This medication does not cause hunger.

It is unusual for appetite to increase with either Metformin or Januvia.

Eating complex carbohydrates helps. Food with good amount of fiber.

He may have what’s called paeudohypoglycemia. Very important to cut back on portions of foods and possible adjust medications as well. He may need a professional continuous glucose monitoring to be able to see his glucose trends and why he is hungry.

He probably has type II diabetes and most likely is on medications that stimulate insulin release or secretion. Low blood sugar can cause hunger. This can BE switched to medications that normalized blood sugar without dropping get and therefore the issue of hunger no longer be present

Talk to your treating MD and consider use of a GLP-1 which suppresses appetite. Drop the Januvia in the Janumet.

This is somewhat curious. Janumet is a combination drug that contains 2 drugs-Januvia and metformin. Both drugs were wt. neutral in controlled studies. If this is the cause of the increased appetite & wt. gain, then the best course is to change medicines. There are now about 20 drugs to treat diabetes & many of them cause wt. loss. In this case, a change to a GLP 1 Receptor Agonist might be best. These agents decrease appetite & usually cause wt. loss. There are several of them on the market- Short acting ones you take 3-3x/d. Intermediate acting you take once daily ( the most popular), & long acting ones you take once a week. The disadvantage to these drugs is they must be taken by injection. They come in a pen with a very tiny needle that you can barely feel so no big deal (I am diabetic and take a once a week one & I cannot feel the needle when I give it). Another disadvantage is cost so look into your insurance. Check with your Dr. about a once daily (such as Victoza) or a weekly one (such as Trilicity orBydureon or a new one called Ozempic). These drugs cause nausea at high doses so start at a low dose and gradually go up. They control blood sugar & wt. loss. Be sure to check blood sugar frequently especially while titrating the dose up & stay at the minimum dose that controls the blood sugar.