Format

Send to

Choose Destination
Diabetes Obes Metab. 2015 Sep;17(9):904-7. doi: 10.1111/dom.12504. Epub 2015 Jul 8.

Fixed ratio dosing of pramlintide with regular insulin before a standard meal in patients with type 1 diabetes.

Author information

1
Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
2
Swedish Pituitary Center, Seattle, WA, USA.
3
AstraZeneca, Gaithersburg, MD, USA.
4
AstraZeneca, San Diego, CA, USA.
5
Consultant, La Jolla, CA, USA.

Abstract

Amylin is co-secreted with insulin and is therefore lacking in patients with type 1 diabetes. Replacement with fixed ratio co-administration of insulin and the amylin analogue pramlintide may be superior to separate dosing. This concept was evaluated in a ratio-finding study. Patients with type 1 diabetes were enrolled in a randomized, single-masked, standard breakfast crossover study using regular human insulin injected simultaneously with pramlintide 6, 9 or 12 mcg/unit insulin or placebo. Insulin dosage was reduced by 30% from patients' usual estimates. Plasma glucose, glucagon and pramlintide and adverse events were assessed. All ratios reduced 0-3-h glucose and glucagon increments by >50%. No hypoglycaemia occurred. Adverse events were infrequent and generally mild. All pramlintide/insulin ratios markedly and safely reduced glycaemic excursions and suppressed glucagon secretion in the immediate postprandial state. Further study using one of these ratios to explore the efficacy and safety of longer-term meal-time and basal hormone replacement is warranted.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01708044.

KEYWORDS:

amylin; pramlintide; type 1 diabetes

PMID:
26040429
PMCID:
PMC4758401
DOI:
10.1111/dom.12504
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center