Diabetic patients have a new way of keeping their blood sugar in check. Last week the FDA approved Januvia, the first in a new class of oral drugs that patients can take alone or in combination with insulin and other treatments. The pills, from Merck, work by inhibiting the breakdown of incretins, hormones that help insulin do its job. "Taking Januvia helps your body work a little bit more normally again," says Dr. James Underberg of New York University School of Medicine, who participated in the clinical trials. Existing oral treatments work by stimulating the pancreas to make more insulin or by helping the insulin your body produces work better. When compared with glipizide, one widely used drug that falls into the former category, Januvia caused fewer cases of hypoglycemia, or low blood sugar. "This gives people a new option in case they don't react well to one of the other medications," says Dr. Richard Jackson, a senior physician at the Joslin Diabetes Center in Boston. Underberg said he would prescribe Januvia in the early stages of type 2. "It gives you another tool to help patients control their sugar sooner rather than later."