Januvia (sitagliptin) is a drug that helps people with Type-2 diabetes control their blood-sugar levels. It was developed by the drug company Merck. The U.S. Food and Drug Administration (FDA) approved Januvia in 2006, and it intended to be used in combination with diet and exercise.

Many people with Type-2 diabetes take a medication to help control their disease and prevent it from getting worse. When a person has Type-2 diabetes, they have chronic problems controlling blood-sugar levels. This is because their cells are resistant to insulin, a hormone that tells cells to absorb glucose (sugar) from the blood. Insulin-resistant cells do not absorb enough blood-sugar, which causes chronic high blood sugar levels.

How does Januvia work?

Januvia works by stimulating the pancreas to produce extra insulin. It also inhibits the liver from releasing sugar into the bloodstream. This combination of effects helps keep a diabetic’s blood-sugar levels from getting too high.

To understand how Januvia works, it helps to first understand a few things about how the body metabolizes food. After a person eats a meal, the body produces hormones called incretins (such as GLP-1) which tell the pancreas to start producing more insulin. To keep the incretins in check, the intestines then release an enzyme called dipeptidyl peptidase-4 (DPP-4), which breaks down incretins and stops the production of insulin. Januvia works by inhibiting DPP-4. Incretins last longer in the body, and stimulate the pancreas to produce extra insulin. The added insulin helps lower the body’s blood-sugar levels.

Januvia Thyroid Cancer

It is unknown whether Januvia causes thyroid cancer. Thyroid cancer has many possible causes, and Januvia is just one potential risk factor. Unfortunately, because Januvia is relatively new, there is no long-term safety data on large numbers of people. Thyroid cancer is very rare and it may take years to develop. Januvia was linked to two cases of thyroid cancer in a 2011 study published in Gastroenterology, which is a warning sign that it could increase the risk of thyroid cancer.

Most people who are diagnosed with thyroid cancer do not suffer life-threatening complications. The disease typically causes symptoms (a lump or “nodule” in the neck) before it grows large enough to spread to other tissues. Less than 1% of people with thyroid cancer get the most aggressive form of the disease (anaplastic thyroid cancer). Treatment for thyroid cancer typically involves surgery to remove the thyroid gland (thyroidectomy). This surgery can be very complicated, because the thyroid gland is located in the lower-front and center of the neck, near major blood vessels, nerves, the windpipe, larynx (voice box), and other structures.

Studies of Januvia and Cancer

In 2011, the journal Gastroenterology published a study linking Januvia to cancer. The researchers looked at the FDA’s Adverse Event Reporting System (AERS). They looked at rates of acute pancreatitis, pancreatic cancer, thyroid cancers, and other cancers, and compared Januvia to other Type-2 diabetes drugs. They found that Januvia was associated with a 2.7-fold increased risk of pancreatic cancer. They also found that Byetta, a diabetes drug that is very similar to Januvia, was associated with an increased risk of thyroid cancer.


Thyroid cancer symptoms include:

  • Lump or “nodule” in the front an center part of the neck
  • Swelling in the neck
  • Changes in tone of voice
  • Pain in the neck or throat
  • Swallowing problems
  • Breathing problems or wheezing
  • Hoarseness
  • Cough
  • Enlarged lymph nodes


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