In a nutshell
This study examined the effects of pramlintide (Symlin) in type 1 diabetes (T1D), and whether the duration of the disease had any impact. It was found that pramlintide was effective in the control of T1D across a range of disease duration.
Some background
Amylin is produced by the pancreas and released with insulin. Like insulin, amylin has glucose-lowering effects. Amylin is deficient in people with T1D. Pramlintide is a drug that mimics the effects of amylin in patients with T1D.
T1D requires lifelong treatment. Patients with T1D tend to experience further loss of pancreatic function, increased weight gain, and increased risk of hypoglycemia (dangerously low blood glucose), with time after diagnosis. For this reason, it is important to evaluate the effectiveness of treatment over time.
Methods & findings
This study looked at 3 trials that compared pramlintide with a placebo (substance with no active effect). 1251 patients were examined in total. 714 received pramlintide with insulin at mealtimes, the rest received a placebo. Both groups were subdivided into 3 further groups, based on the time since their diagnosis with T1D. The average disease durations were 6.7, 16.5, and 29.9 years in each group. Patients were asked not to change their existing insulin therapy, diet, or exercise program. They were reassessed after 26 weeks.
Patients who were treated with pramlintide experienced greater reductions in HbA1c (average blood glucose over the past 3 months) regardless of the duration of their diabetes. Patients who were treated with pramlintide lost weight, while those who received placebo gained weight. Weight at the beginning of the study was more important than duration of T1D in predicting the amount of weight lost.
45.4% of patients receiving pramlintide experienced nausea. This is roughly 3 times greater than in patients receiving the placebo. The number of severe hypoglycemic events was roughly the same in both groups. In both groups, longer duration of T1D was associated with a roughly 4% higher risk of severe hypoglycemia.
The bottom line
The study concluded that pramlintide is effective in reducing HbA1c levels and body weight when taken with insulin. This effect is seen across a wide range of disease durations.
The fine print
This study was funded by Amylin Pharmaceuticals, and all of the authors were employees. Amylin Pharmaceuticals manufactures pramlintide. Furthermore, patients of non-Caucasian descent made up less than 10% of participants. As such, the results may not be applicable to all individuals.
What’s next?
Discuss the use of pramlintide, or other amylin-mimicking drugs, with your physician.
Published By :
Advances in therapy
Date :
Apr 12, 2016
