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Pediatr Diabetes. 2009 Jun;10(4):264-8. doi: 10.1111/j.1399-5448.2008.00490.x. Epub 2008 Dec 18.

Reducing postprandial hyperglycemia with adjuvant premeal pramlintide and postmeal insulin in children with type 1 diabetes mellitus.

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Section of Endocrinology and Metabolism, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.



The purpose of this study was to determine the effect of adjuvant premeal pramlintide with postmeal insulin on postprandial hyperglycemia in children with type 1 diabetes mellitus (T1DM).


Eight adolescents with T1DM on intensive insulin therapy participated in an open-label, non-randomized, crossover study, comparing postprandial glucose excursions in study A (prescribed insulin regimen and given premeal) vs. study B (pramlintide + insulin). Prandial insulin dose for study B was decreased by 20% and given postmeal, while pramlintide was given just before the meal. Blood glucose (BG), glucagon, and pramlintide concentrations were measured basally and at timed intervals during a 300-min study period.


Postprandial incremental BG for the duration of the study was reduced in study B vs. study A with AUC((-60 to 300 min)) (area under the curve) at 6600 +/- 2371 vs. 20 230 +/- 3126 mg/dL/min (367 +/- 132 vs. 1124 +/- 174 mmol/L/min) (p < 0.001). Glucagon concentration was suppressed for approximately 120 min following administration of 30 microg of pramlintide and postmeal insulin (p < 0.003). No severe hypoglycemic episodes were experienced in this study.


Postprandial hyperglycemia is considerably reduced in adolescents with T1DM when treated with fixed-dose premeal pramlintide, and precisely calculated postmeal insulin, without significant side effects.

[Indexed for MEDLINE]

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