Amylin Analogs Pramlintide

Amylin is a 37 amino acid peptide that is formed almost exclusively within pancreatic P-cells and co-secreted with insulin. Amylin acts as a neuroendocrine signal that complements the actions of insulin in postprandial glucose homeostasis via suppression of postprandial glucagon secretion and via inhibition of gastric emptying. Individuals with T1DM have an absolute deficiency of both insulin and amylin, whereas individuals with T2DM have a relative deficiency of both hormones.

Pramlintide is the first amylin analog commercially available and received FDA approval in March 2005 for therapy in both T1DM and T2DM. Pramlintide, studied as an adjunctive therapy to insulin, has been shown to improve postprandial and overall glycemic control in individuals with both T1DM and T2DM (improvements in HbA1C of 0.67%82 and HbA1C of 0.62%,83 respectively) without increasing the incidence of hypoglycemia or weight gain. The glycemic improvements with pramlintide had no significant effects on lipid concentrations or blood pressure and showed no evidence of cardiac, hepatic, or renal toxicity. The most frequent adverse side effects associated with pramlintide therapy include transient mild to moderate nausea and anorexia. In its current formulation, pramlintide is administered via subcutaneous injection separately from insulin.

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