5 foods to avoid while taking Januvia

In this article:

• How Januvia works
• 5 foods to avoid with Januvia
• Herbs and supplements to avoid with Januvia
• What should you eat while taking Januvia?
• Gastrointestinal side effects of Januvia

In this article

• How Januvia works
• 5 foods to avoid with Januvia
• Herbs and supplements to avoid with Januvia
• What should you eat while taking Januvia?
• Gastrointestinal side effects of Januvia

Some people with diabetes need more than dietary changes and regular exercise to manage the condition. Prescription drugs like Januvia (sitagliptin) can help maintain healthy blood sugar levels. Manufactured by Merck, Januvia is a once-daily tablet that lowers blood sugar when it rises too high (hyperglycemia).

Januvia is FDA approved for people with Type 2 diabetes. However, it may be used off-label for conditions like metabolic syndrome and polycystic ovarian syndrome (PCOS), according to Daniel Kim, DO, a family physician with Medical Offices of Manhattan.

Unlike many medications, there aren’t any foods that directly interact with Januvia. However, you should still try to moderate or avoid certain foods because of their impact on your blood sugar, such as sugary foods, refined carbs, and alcohol. Here’s what to know about the foods to avoid on Januvia.

How Januvia works

Januvia belongs to a class of medications known as dipeptidyl peptidase 4 (DPP-4) inhibitors, which means it blocks certain enzymes that make it harder for your body’s metabolic hormones to keep your blood sugar levels stable after you eat.

In doing this, Januvia helps to prevent post-meal glucose spikes in the blood, says Libu Varughese, MD, endocrinologist and medical advisor for Aeroflow Diabetes, noting that it works particularly well in the two hours after a meal to make sure your blood sugar doesn’t get too high or too low.

In the short-term, Dr. Kim says Januvia can have an impact on your blood sugar levels within a few hours of taking it; in the long-term, he says you may see improvements in high blood sugar levels after a few weeks of starting the medication.

5 foods to avoid with Januvia

According to Dr. Varughese, you don’t need to worry about the foods you eat interfering with Januvia or preventing it from working. However, foods that cause dramatic glucose spikes are generally not recommended for people with Type 2 diabetes, and they can make it harder for Januvia to have the same effect on your blood sugar.

1. Sugary foods and drinks

People taking DPP-4 inhibitors like Januvia should limit or avoid foods and drinks with a high sugar content. Sugary snacks and beverages cause a rapid spike in blood sugar levels, says Dr. Varughese, making Januvia less effective at stabilizing your glucose.

For the most part, this means moderating your intake of cake and candy, sodas and fruit juices, and other pre-packaged treats, but not necessarily fruits that contain natural sugars, like bananas and grapes. Though fruit should be eaten in moderation if you have Type 2 diabetes, you don’t have to avoid it completely (and thanks to other nutrients, like fiber, fruit is a much healthier choice than a bowl of ice cream!).

2. Refined carbohydrates

There are two types of carbohydrates: simple (refined) and complex. Refined carbs are processed and don’t have as many nutrients, plus they’re digested quickly and can cause your blood sugar to spike; complex carbs, on the other hand, are whole grains full of fiber and other vitamins, and they cause a slow and steady blood sugar increase that’s recommended for people with Type 2 diabetes.

As much as possible, you should focus on eating complex carbs such as oats, barley, brown rice, and beans instead of refined carbs like white rice, white pasta, snack crackers, pretzels, and sugary cereals, especially when taking Januvia. These complex carbs won’t cause a spike in blood sugar and will allow your medication to keep your glucose levels in check more efficiently.

3. Starchy vegetables

While vegetables, in general, are diabetic diet-friendly, it’s best to limit the ones that are high in starch because they are also higher in carbohydrates—and the more carbohydrates in a food, the more it contributes to a rise in blood sugar. Starchy vegetables include potatoes, corn, winter squash, and peas. That doesn’t mean you can’t eat them at all; these starchy vegetables have more carbs than their non-starchy counterparts, but they’re complex carbs (meaning they’re still better for you than the simple carbs found in white bread or rice).

However, if your diabetes diet plan requires you to count carbs closely while taking Januvia, you’ll be able to eat more non-starchy vegetables like broccoli, eggplant, green beans, carrots, and zucchini, and that will help you feel fuller and more satisfied without the sharp rise in blood glucose levels.

4. Alcohol

Alcohol contains varying amounts of carbohydrates (depending on what type you’re drinking and whether it’s been mixed with other ingredients), which can make it hard for people with diabetes to accurately evaluate how alcohol fits into their daily diet.

Though that’s important to keep in mind, it’s not the main reason why many experts recommend moderating your alcohol intake while taking diabetes medications like Januvia. It’s actually because alcohol lowers your blood sugar thanks to the way it’s processed in your liver. When you combine alcohol with glycemic-lowering medications like Januvia, you’re at risk of hypoglycemia or dangerously low levels of blood sugar.

You may not need to stop drinking alcohol entirely, but you should talk to your healthcare provider about how to safely consume it while taking Januvia. There are ways to reduce the risk of hypoglycemia, like never drinking on an empty stomach and knowing the symptoms of low blood sugar.

5. Excessive caffeine

For most people without diabetes, the normal amount of caffeine (i.e., 400 milligrams or less) won’t affect your blood sugar, but for people with diabetes, that threshold may be somewhat lower.

Though some studies suggest caffeine can have a protective effect on insulin resistance, reducing your risk for Type 2 diabetes, the fact that caffeine can affect insulin levels at all means people with diabetes who consume caffeine need to monitor themselves closely—especially when taking medications like Januvia—to make sure their blood sugar isn’t rising too high or falling too low. (Remember that caffeine is usually consumed in coffee but can also be found in other beverages, like black tea, some sodas, and energy drinks.)

Like alcohol, the amount of caffeine you can safely consume will be individualized to your body and your diet. A 2019 study shows that caffeine may raise blood sugar in the short term while improving glucose levels over time, so caffeinated beverages like coffee may still be part of your daily diet as long as you’re not overdoing it.

Herbs and supplements to avoid with Januvia

Like foods and drinks, there are no reports of over-the-counter herbs or supplements directly interfering with Januvia. Still, several vitamins and minerals can affect blood sugar levels and should generally be avoided (or used with caution) if you have Type 2 diabetes.

You should always talk to your healthcare provider before taking any herbs or vitamins, but people on Januvia should be especially careful about the following supplements:

• Chromium
• Niacin
• Ginseng
• St. John’s wort

These supplements may raise or lower your blood sugar levels, affecting how well Januvia works, or in the case of St. John’s wort, may decrease the effectiveness of the drug.

What should you eat while taking Januvia?

Because there’s no interaction between Januvia and any foods, nothing you eat will help your body better absorb the medication or make it work better. But Dr. Varughese says the ideal foods to eat while taking Januvia are ones with a low glycemic index; these foods raise blood sugar levels slowly and steadily rather than in a dramatic spike.

The most common low glycemic index foods include:

• Barley, oats, and quinoa
• Carrots and leafy green vegetables
• Apples and oranges
• Nuts and beans
• Lean protein, like chicken, fish, and eggs
• Low-fat dairy, including milk, yogurt, and hard cheeses (like cheddar)

Some of these foods can also actively lower blood sugar levels, making them an especially good choice for anyone with Type 2 diabetes.

Gastrointestinal side effects of Januvia

All DPP-4 inhibitors can cause mild digestive side effects, says Dr. Kim, including nausea, diarrhea, and abdominal pain. Some people also report constipation or other changes to bowel movements with these drugs, including Januvia.

If you take Januvia, you may not experience digestive problems, but Dr. Kim says it can help to start with a low dose of Januvia and increase gradually, take your medication with food, and stay hydrated. If you’re on Januvia and can’t keep any food down or become dehydrated, you should contact a healthcare provider as soon as possible.

In addition to GI side effects, the most common side effects of Januvia include:

• Upper respiratory infection
• Stuffy or runny nose
• Sore throat
• Headache

Serious side effects of Januvia include:

• Kidney problems that may require dialysis
• Low blood sugar (hypoglycemia), especially when combined with other blood-sugar-reducing medications like sulfonylurea or insulin
• Serious allergic reactions
• Severe joint pain
• Bullous pemphigoid, a skin reaction causing skin erosion and blistering

Drug interactions may occur with certain medications. For example, when combined with the diabetes drugs metformin or rosiglitazone, swelling of the hands or legs may occur. It is unknown if Januvia transfers to breast milk, so breastfeeding women should seek medical advice before using the medication.

The primary complications of Januvia are pancreatitis (inflammation of the pancreas) and worsening of congestive heart failure (for people who already have this condition), says Dr. Varughese.

Symptoms of pancreatitis include abdominal pain, nausea, fever, and weakness. Individuals with the following medical conditions are at greater risk of developing pancreatitis:

• A history of pancreatitis
• High blood triglyceride levels
• Gallstones
• Kidney problems
• A history of alcoholism

If you have symptoms of heart failure, including any shortness of breath, fast heartbeat, extreme fatigue, weight gain with swelling in the stomach, feet, legs, and ankles, or sudden and severe abdominal pain while taking Januvia, seek emergency medical attention from a healthcare professional.