Januvia vs. Afrezza for Diabetes Type 2: Important Differences and Potential Risks.

Key takeaways

Januvia (sitagliptin) and Afrezza (insulin human) are both medications used to manage diabetes, but they belong to different medication classes and have distinct uses. Januvia is a dipeptidyl peptidase-4 (DPP-4) inhibitor taken orally once daily, while Afrezza is an ultra rapid-acting insulin that is inhaled at the start of meals. Januvia is specifically approved for Type 2 diabetes, whereas Afrezza is approved for both Type 1 and Type 2 diabetes. Januvia does not typically cause weight changes, but Afrezza can lead to weight gain. Common side effects of Januvia include a runny nose and sore throat, while Afrezza may cause low blood sugar and cough. Afrezza is not suitable for people with lung conditions like asthma or chronic obstructive pulmonary disease (COPD), whereas Januvia requires caution in those with kidney issues. Additionally, both medications can be combined with other diabetes medications for better blood sugar control, but this requires blood sugar monitoring due to the increased risk of low blood sugar.

Januvia

(sitagliptin)

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Afrezza

(insulin)

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Summary for Januvia

Prescription only

Januvia (sitagliptin) is a prescription medication that helps lower blood sugar in adults with Type 2 diabetes. It works best when you also follow a balanced diet and exercise regularly. It belongs to the drug class called dipeptidyl peptidase-4 (DPP-4) inhibitors, or gliptins. Januvia (sitagliptin) comes as a tablet you take by mouth once a day. Side effects include stuffy or runny nose and headache. Januvia (sitagliptin) is a brand-name medication only; the generic version isn't available yet.

Indications for Januvia

Type 2 diabetes in adults

Pros and Cons for Januvia

Pros

Taken once a day
Not likely to affect your body weight

Cons

Not for people with Type 1 diabetes
Possible risk of severe joint pain

Common Side Effects for Januvia

Runny or stuffy nose and other symptoms of the common cold (5%)

Warnings for Januvia

Inflammation of the pancreas (pancreatitis)
Risk of heart failure
Sudden kidney problems
Low blood sugar when taken with other diabetes medications
Serious allergic reactions
Joint pain
Severe skin reactions

Summary for Afrezza

Prescription only

Afrezza is an ultra rapid-acting inhaled insulin for adults with diabetes. It helps manage blood sugar levels from meals. You breathe in the medication through the mouth using the Afrezza inhaler usually at the start of meals. Common side effects are low blood sugar and cough. There's also a risk of bronchospasm (sudden narrowing of the airways), which can make it hard to breathe. So Afrezza (insulin) isn't for people with breathing problems like asthma or chronic obstructive pulmonary disease (COPD).

Indications for Afrezza

Type 1 diabetes (T1D) in adults
Type 2 diabetes (T2D) in adults

Pros and Cons for Afrezza

Pros

A good choice for people who don't want to use injectable insulin
Can help people with either Type 1 or Type 2 diabetes manage blood sugar
Starts to work in about 12 minutes and lasts between 1.5 and 3 hours, depending on your dose

Cons

Might need to use more than one cartridge of insulin for your dose (if you need more than 12 units of insulin)
Not for people who smoke or for people with breathing problems (e.g., asthma, COPD)
Not approved for children

Common Side Effects for Afrezza

Low blood sugar (up to 67%)
Cough (up to 29%)
Throat pain or irritation (up to 6%)
Headache (up to 5%)

Warnings for Afrezza

Breathing problems
Low blood sugar levels (hypoglycemia)
Changes in blood sugar levels with changes to your insulin routine
Diabetic ketoacidosis
Low potassium levels
Swelling from fluid buildup and risk of heart failure when taken with certain diabetes medications