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Posted by on Dec 30, 2018 in Diabetes mellitus | 0 comments

In a nutshell

The aim of this study was to investigate the effectiveness of pramlintide (Symlin) with insulin on blood glucose control in a 24-hour period. The main finding of the study was that pramlintide improved blood glucose after meals and reduced the fluctuation in blood glucose levels in patients with type 1 diabetes (T1D).

Some background

In healthy individuals, the pancreas produces hormones called insulin and amylin. Insulin is the main hormone that controls blood glucose. Amylin is a hormone also involved blood glucose control that prevents blood glucose spikes after meals. In T1D, the pancreas stops producing both hormones. 

Insulin replacement is the main treatment for T1D. Insulin can be given by several injections per day or continuously by an insulin pump. However, this is commonly ineffective in regulating blood glucose levels in a high number of patients with T1D. This happens mostly because it does not effectively prevent blood glucose spikes after meals. Pramlintide is an injectable version of amylin hormone. It is unknown whether giving pramlintide with insulin can prevent these blood glucose spikes after meals in patients with T1D.

Methods & findings

This study included 27 patients with T1D who were using an insulin pump. Patients were randomly assigned to receive either pramlintide or a placebo via a separate pump. This treatment was given in a fixed ratio of 9 mg per unit of insulin that the patient received. This was done for a 24-hour period.

Average blood glucose level over the 24-hour period was significantly lower in the patients who received pramlintide (8.5 mmol/L) compared to those who received the placebo (9.7 mmol/L). This was because there was almost no increase in blood glucose level after meals in patients who received pramlintide. There was much less fluctuation in blood glucose levels throughout the 24-hour period in patients who received pramlintide in comparison to the placebo group.

The pramlintide group experienced more gastrointestinal side effects (47%) compared to the placebo group (7%). Minor hypoglycemia (dangerously low blood glucose levels) occurred in 22% of patients treated with pramlintide and 29% of patients in the placebo group.

The bottom line

The authors concluded that giving pramlintide, along with insulin for 24-hours improved after-meal blood glucose spikes and reduced fluctuations in blood glucose in patients with T1D.

The fine print

This study was funded by AstraZeneca, the developer of pramlintide. Also, this was a very small study that only evaluated this treatment for 24 hours. Further, larger studies are needed.

Published By :

Diabetes Care

Date :

Sep 17, 2018

Original Title :

Control of Postprandial Hyperglycemia in Type 1 Diabetes by 24-Hour Fixed-Dose Coadministration of Pramlintide and Regular Human Insulin: A Randomized, Two-Way Crossover Study.

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