The effect of single doses of pramlintide on gastric emptying of two meals in men with IDDM
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In a previous study we have shown that an intravenous infusion of pramlintide (an analogue of human amylin) delayed gastric emptying, but the dose of pramlintide was supraphysiological in relation to the amylin response to food in non-diabetic subjects. The purpose of this study was to examine the dose response relationship of subcutaneous injections of pramlintide on gastric emptying and to determine whether administration of the drug before one meal has an impact on the subsequent meal. Eleven men with insulin-dependent diabetes mellitus were studied in a double-blind, randomised, four-way crossover design. None had autonomic neuropathy. Euglycaemia was maintained overnight before the study day. At -30 min the patients self-injected their usual morning insulin and at -15 min they injected the study drug (either placebo or 30, 60 or 90 microg pramlintide) subcutaneously. At 0 min they ate a standard meal consisting of a pancake, labelled with 99mTc, and a milkshake containing 3-ortho-methylglucose (3-OMG). Gastric emptying images were obtained for the next 8 h. At 240 min the subjects ate a similar meal, but on this occasion the pancake was labelled with (111)In. All three doses of pramlintide delayed emptying of the solid component of the first meal (p < 0.004) with no significant difference between the drug doses. There were no differences between placebo and pramlintide after the second meal. All three doses of pramlintide resulted in a prolongation in the time to peak plasma 3-OMG level (p < 0.0001) after the first meal but there was no difference after the second meal.
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Injection of pramlintide prior to meals acts to suppress glucagon secretion, delay gastric emptying, and promote satiety.
“Injection prior to meals acts to suppress glucagon secretion, delay gastric emptying, and promote satiety (247-250).”
From The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2021) · cites this paper as [248]
The Results report that pramlintide was injected before the meal, and the gastric-emptying findings report delayed emptying of the first meal in men with IDDM. The paper does not report suppression of glucagon secretion or promotion of satiety; searches for those effects returned no supporting passage. Page numbers were unavailable in our copy. (LLM, conf=0.88)
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- Authors
- Kong, M.-F., Stubbs, T. A., King, P., Macdonald, I. A., Lambourne, J. E., Blackshaw, P. E., Perkins, A. C., & Tattersall, R. B.
- Affiliations
- Queen's Medical Centre (GB)
- University of Nottingham (GB)
- Nottingham University Hospitals NHS Trust (GB)
- Venue
- Diabetologia
- Published
- 1998-04-21
- Volume
- 41
- Issue
- 5
- Pages
- 577-583
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2041827953
- Cited by
- 106
- References
- 27
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 3 · 2015: 1 · 2014: 4 · 2013: 3 · 2012: 2
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Amylin Pharmaceuticals
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- pramlintide, amylin analogues, gastric emptying, type 1 diabetes, dose-response relationship, subcutaneous injection, plasma glucose response, autonomic neuropathy
- MeSH terms
- Adult, Amyloid, Blood Glucose, Energy Intake, Diabetes Mellitus, Type 1, Dose-Response Relationship, Drug, Double-Blind Method, Food, Gastric Emptying, Humans, Hypoglycemic Agents, Insulin, Male, Cross-Over Studies, 3-O-Methylglucose, Islet Amyloid Polypeptide
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