In a nutshell
This study examined whether adjusting the dose of pramlintide based on the insulin dose is safe and effective.
Some background
Amylin is a hormone produced by the pancreas which delays the passage of food through the stomach and therefore reduces appetite, resulting in weight loss. Amylin and insulin (hormone which reduces blood sugar levels) are both secreted from the pancreas. However, the immune attack on the pancreas results in the loss of both insulin and amylin in patients with type 1 diabetes (T1D).
Pramlintide (Symlin) is drug which mimics the effect of amylin. Like insulin, pramlintide is also injected under the skin. It is usually given as a fixed dose before meals. However, hypoglycaemia (dangerously low blood glucose levels) can occur when the dose of pramlintide and insulin are not matched to the meal. Therefore, adjusting the pramlintide dose based on the insulin dose would allow for a fixed pramlintide:insulin ratio and may lead to a reduction in side effects.
Methods & findings
This study aimed to determine whether a fixed pramlintide:insulin ratio can reduce side effects in T1D patients.
This study involved 19 T1D patients divided into 4 groups. One group received 6 mcg of pramlintide per unit of insulin. Another group received 9 mcg of pramlintide per unit of insulin. Another group received 12 mcg of pramlintide per unit of insulin. The remaining group received a placebo (substance with no therapeutic effect).
Insulin was administered by injection or using an insulin pump at a dose 30% less than normal. Participants received the pramlintide and insulin before breakfast. Blood glucose levels were measured at regular intervals for 3 hours after the meal.
Participants in all three groups receiving pramlintide had a reduction in blood glucose levels. In addition, the production of glucagon (hormone which increases blood glucose levels) was reduced.
Participants did not experience hypoglycemia. However, five participants experienced side effects, including mild nausea, diarrhea and severe abdominal pain.
The bottom line
This study concluded that varying the dose of pramlintide is safe and effective in the short-term.
The fine print
The authors received funding from AstraZeneca, the company who developed the drug. Some of the authors were also employed by AstraZeneca.
What’s next?
Consult your physician regarding the risks and benefits of pramlintide.
Published By :
Diabetes, Obesity and Metabolism
Date :
Jun 04, 2015
