Pramlintide but Not Liraglutide Suppresses Meal-Stimulated Glucagon Responses in Type 1 Diabetes
Open accessAbstract
Context: Postprandial hyperglycemia remains a challenge in type 1 diabetes (T1D) due, in part, to dysregulated increases in plasma glucagon levels after meals. Objective: This study was undertaken to examine whether 3 to 4 weeks of therapy with pramlintide or liraglutide might help to blunt postprandial hyperglycemia in T1D by suppressing plasma glucagon responses to mixed-meal feedings. Design: Two parallel studies were conducted in which participants underwent mixed-meal tolerance tests (MMTTs) without premeal bolus insulin administration before and after 3 to 4 weeks of treatment with either pramlintide (8 participants aged 20 ± 3 years, hemoglobin A1c 6.9 ± 0.5%) or liraglutide (10 participants aged 22 ± 3 years, hemoglobin A1c 7.6 ± 0.9%). Results: Compared with pretreatment responses to the MMTT, treatment with pramlintide reduced the peak increment in glucagon from 32 ± 16 to 23 ± 12 pg/mL (P < 0.02). In addition, the incremental area under the plasma glucagon curve from 0 to 120 minutes dropped from 1988 ± 590 to 737 ± 577 pg/mL/min (P < 0.001), which was accompanied by a similar reduction in the meal-stimulated increase in the plasma glucose curve from 11,963 ± 1424 mg/dL/min pretreatment vs 2493 ± 1854 mg/dL/min after treatment (P < 0.01). In contrast, treatment with liraglutide had no effect on plasma glucagon and glucose responses during the MMTT. Conclusions: Adjunctive treatment with pramlintide may provide an effective means to blunt postmeal hyperglycemia in T1D by suppressing dysregulated plasma glucagon responses. In contrast, plasma glucose and glucagon responses were unchanged after 3 to 4 weeks of treatment with liraglutide.
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Newer therapeutic agents including GLP-1 receptor agonists and GIP plus GLP dual agonists may decrease cardiovascular disease and diabetic kidney disease.
“In addition, these newer therapeutic agents may decrease cardiovascular disease (CVD) 20 and diabetic kidney disease (DKD), 21 the major life-shortening complications of diabetes.[22][23][24]”
From Effectiveness of Semaglutide and Tirzepatide in Overweight and Obese Adults with Type 1 Diabetes (2025) · cites this paper as [24]
The Introduction discusses postprandial glucose control and the risk of complications, but does not say these agents reduce cardiovascular disease or diabetic kidney disease. The Results address meal-stimulated glucose and glucagon responses in type 1 diabetes. Searches for cardiovascular, kidney, and renal outcomes found no passage supporting the attributed claim; our copy is not truncated. (LLM, conf=0.76)
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- Authors
- Galderisi, A., Sherr, J., VanName, M., Carria, L., Zgorski, M., Tichy, E., Weyman, K., Cengiz, E., Weinzimer, S., & Tamborlane, W.
- Affiliations
- University of Padua (IT)
- Yale University (US)
- Corresponding author
- Galderisi, Alfonso
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2017-12-01
- Volume
- 103
- Issue
- 3
- Pages
- 1088-1094
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC6276715
- OpenAlex
- W2773058392
- Cited by
- 25
- References
- 33
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 3 · 2016: 1
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion, other-oa)
- Funders
- Eli Lilly and Company
- Sanofi
- Yale University
- Bigfoot Biomedical
- Insulet Corporation
- Novo Nordisk
- International Society for Pediatric and Adolescent Diabetes
- National Institutes of Health (UL1TR000142, UL1-TR-, DK-45735)
- Raymond and Beverly Sackler Institute for Biological, Physical and Engineering Sciences, Yale University
- National Institute of Diabetes and Digestive and Kidney Diseases (K12DK094714, R01DK085618, P30DK045735)
- National Center for Advancing Translational Sciences
- Yale Center for Clinical Investigation, Yale School of Medicine
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- pramlintide, liraglutide, type 1 diabetes, glucagon, postprandial hyperglycemia, mixed meal tolerance test, incretin-based therapy, glucagon suppression, plasma glucose response
- MeSH terms
- Liraglutide, Adolescent, Adult, Blood Glucose, Diabetes Mellitus, Type 1, Female, Glucagon, Glycated Hemoglobin, Humans, Hyperglycemia, Hypoglycemic Agents, Male, Treatment Outcome, Postprandial Period, Young Adult, Islet Amyloid Polypeptide, Meals
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