Review of pramlintide as adjunctive therapy in treatment of type 1 and type 2 diabetes
Open accessAbstract
Pramlintide (Symlin), a synthetic analog of a neurohormone amylin, was approved by the US Food and Drug Administration for use along with premeal insulin in patients with type 1. In patients with type 2 diabetes, pramlintide is approved for addition to pre-meal insulin in those patients who are either only on pre-meal insulin or those receiving the combination of insulin and metformin and/or a sulfonylurea. This article reviews the pharmacology, pharmacokinetics, dosing, clinical trials, safety, contraindications, and drug interactions of pramlintide therapy. A search for published clinical trials and therapeutic reviews in the English language was done in the following databases: Iowa Drug Information Service (1966 to July 2008), MEDLINE (1966 to July 2008), and International Pharmaceutical Abstracts (1970 to July 2008). Pramlintide and amylin were used as keywords and title words. References of key articles were also reviewed to identify additional publications. Amylin is a 37 amino acid peptide neurohormone co-secreted from the beta cells of the pancreas, along with insulin, in response to meals. Amylin lowers serum glucose by decreasing glucagon release, slowing gastric emptying and decreasing food intake. Pramlintide, a synthetic analog of amylin, reduces 2-hour postprandial blood glucose between 3.4 and 5 mmol/L, reduces A1C by 0.2% to 0.7% and has no effect on fasting glucose levels. The use of pramlintide was associated with up to a 1.6 kg weight loss. Nausea was the most commonly reported adverse event. Pramlintide is an amylin analog that was FDA approved for the treatment of type 1 and type 2 diabetes. Its use results in modest reduction of A1C and the most frequent side effects are hypoglycemia and nausea.
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Pramlintide has been shown to reduce postprandial hyperglycaemia, bodyweight, insulin dosage, and HbA1C concentrations, and to reduce postprandial glucagon and glucose excursions and slow gastric emptying.
“The hormone pramlintide has been shown to reduce postprandial hyperglycaemia, bodyweight, insulin dosage, and HbA1C concentrations, and to reduce postprandial glucagon and glucose excursions and slow gastric emptying.102”
From Type 1 diabetes (2014) · cites this paper as [102]
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Cites
Cooper, G. J., Willis, A. C., Clark, A., Turner, R. C., Sim, R. B., & Reid, K. B. (1987) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.84.23.8628 · Cited by 1,299 · see citing works
Projection of Diabetes Burden Through 2050
Boyle, J. P., Honeycutt, A. A., Narayan, K. M. V., Hoerger, T. J., Geiss, L. S., Chen, H., & Thompson, T. J. (2001) · Diabetes Care · doi:10.2337/diacare.24.11.1936 · Cited by 1,004 · cited 3× · see citing works
“As blood glucose approaches euglycemia, the risk for hypoglycemia increases (United Kingdom Prospective Diabetes Study Group 1998a, b; Boyle et al 2001).”
InfluentialDiagnosis and Classification of Diabetes Mellitus
American Diabetes Association (2006) · Diabetes Care · doi:10.2337/diacare.29.s1.06.s43 · Cited by 924 · see citing works
Hollander, P. A., Levy, P., Fineman, M. S., Maggs, D. G., Shen, L. Z., Strobel, S. A., Weyer, C., & Kolterman, O. G. (2003) · Diabetes Care · doi:10.2337/diacare.26.3.784 · Cited by 307 · see citing works
Whitehouse, F., Kruger, D. F., Fineman, M., Shen, L., Ruggles, J. A., Maggs, D. G., Weyer, C., & Kolterman, O. G. (2002) · Diabetes Care · doi:10.2337/diacare.25.4.724 · Cited by 264 · see citing works
Fineman, M. S., Koda, J. E., Shen, L. Z., Strobel, S. A., Maggs, D. G., Weyer, C., & Kolterman, O. G. (2002) · Metabolism · doi:10.1053/meta.2002.32022 · Cited by 129 · see citing works
Riddle, M., Frias, J., Zhang, B., Maier, H., Brown, C., Lutz, K., & Kolterman, O. (2007) · Diabetes Care · doi:10.2337/dc07-0589 · Cited by 116 · see citing works
The effect of single doses of pramlintide on gastric emptying of two meals in men with IDDM
Kong, M.-F., Stubbs, T. A., King, P., Macdonald, I. A., Lambourne, J. E., Blackshaw, P. E., Perkins, A. C., & Tattersall, R. B. (1998) · Diabetologia · doi:10.1007/s001250050949 · Cited by 106 · see citing works
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Research works printed but not linked: 34
- American Diabetes Association 2008 Economic costs of diabetes in the US in 2007 Diabetes Care 31 596 615 18308683
- Beaumont K Kenney MA Young AA 1993 High affinity amylin binding sites in rat brain Mol pharmacol 44 493 7 8396712
- Diabetes Control and Complications Research Trial Group 1993 The effect of intensive treatment of diabets on development and progression of long-term complication in insulin dependent diabetes mellitus N Engl J Med 329 77 986 8366922
- Edelman S Garg S Frias J 2006 A double-blind, placebo-controlled trial assessing pramlintide treatment in the setting of intensive insulin therapy in type 1 diabetes Diabetes Care 29 189 95 17003291
- Elkind-Hirsch K Butler WJ Bhushan M 2008 Clinical experience with the addition of pramlintide in patients with insulin-requiring type 2 diabetes Diabetes Care 31 39 40 17909093
- Fineman M Weyer C Maggs D G 2002a The human amylin analog, pramlintide, reduces postprandial hyperglucagonemia in patients with type 2 diabetes mellitus Horm Metab Res 34 504 8 12384827
- Grabauska G Zhou S Das S 2004 Prolactin-releasing peptide affects gastric motor function in rat by modulating synaptic transmssion in the dorsal vagal complex J Physiol 561 821 39 15486017 PMC1665377
- Hoerger TJ Segel JE Gregg EW 2008 Is glycemic control improving in US adults? Diabetes Care 31 81 6 17934153
- Hollander P Ratner R Fineman M 2003a Addition of pramlintide to insulin therapy lowers HbA1c in conjunction with weight loss in patients with type 2 diabetes approaching glycaemic targets Diabetes Obes Metab 5 408 14 14617226
- Kellmeyer TA Kesty NC Wang Y 2007 Pharmacokinetics of an oral drug (acetaminophen) administered at various times relative to subcutaneous injection of pramlintide in subjects with type 2 diabetes J Clin Pharmacol 47 798 805 17463219
- Koda JE Fineman M Rink TJ 1992 Amylin concentrations and glucose control Lancet 339 1179 80 1349407
- Kong MF King P MacDonald IA 1997 Infusion of pramlintide, a human amylin analogue, delays gastric emptying in men with IDDM Diabetologia 40 82 8 9028722
- Levetan C Want LL Weyer C 2003 Impact of pramlintide on glucose fluctuations and postprandial glucose, glucagon, and triglyceride excursions among patients with type 1 diabetes intensively treated with insulin pumps Diabetes Care 26 1 8 12502651
- Lutz T Mollet A Rushing P 2001 The anorectic effect of a chronic peripheral infusion of amylin is abolished in area postrema/nucleus of solitary tract (AP/NTS) lesioned rats Int J Obes Relat Metab Disord 25 1005 11 11443499
- Maggs D Shen L Strobel S 2003 Effect of pramlintide on A1C and body weight in insulin-treated African Americans and Hispanics with type 2 diabetes: a pooled post hoc analysis Metabolism 52 1638 42 14669170
- Maggs DG Fineman M Kornstein J 2004 Pramlintide reduces postprandial glucose excursions when added to insulin lispro in subjects with type 2 diabetes: a dose-timing study Diabetes Metab Res Rev 20 55 60 14737746
- Marrero DG Crean J Zhang B 2007 Effect of adjunctive pramlintide treatment on treatment satisfaction in patients with type 1 diabetes Diabetes Care 30 210 6 17259483
- Martinez A Kapas S Miller MJ 2000 Coexpression of receptors for adrenomedullin, calcitonin gene-related peptide, and amylin in pancreatic beta-cells Endocrinology 141 406 11 10614663
- Nyholm B Orskov L Hove KY 1999 The amylin analog pramlintide improves glycemic control and reduces postprandial glucagon concentrations in patients with type 1 diabetes mellitus Metabolism 48 935 41 10421239
- Pittner R Albrandt K Beaumont K 1994 Molecular physiology of amylin J Cell Biochem 555 19 28 7929615
- Ratner RE Dickey R Fineman M 2004 Amylin replacement with pramlintide as an adjunct to insulin therapy improves long-term glycaemic and weight control in Type 1 diabetes mellitus: a 1-year, randomized controlled trial Diabetic Medicine 21 1204 12 15498087
- Ratner RE Want LL Fineman MS 2002 Adjunctive therapy with the amylin analogue pramlintide leads to a combined improvement in glycemic and weight control in insulin-treated subjects with type 2 diabetes Diabetes Technol Ther 4 51 61 12017421
- Rubin RR Peyrot M 2007 Assessing treatment satisfaction in patients treated with pramlintide as an adjunct to insulin therapy Curr Med Res Opin 23 1919 29 17624233
- Sexton PM Paxinos G Kenney MA 1994 In vitro autoradiographic localization of amylin binding sites in rat brain Neuroscience 62 553 67 7830897
- Thompson RG Gottlieb A Organ K 1997a Pramlintide: a human amylin analogue reduced postprandial plasma glucose, insulin, and C-peptide concentrations in patients with type 2 diabetes Diabet Med 14 547 55 9223392
- Thompson RG Pearson L Kolterman OG 1997b Effects of 4 weeks’ administration of pramlintide, a human amylin analogue, on glycaemia control in patients with IDDM: effects on plasma glucose profiles and serum fructosamine concentrations Diabetologia 40 1278 85 9389419
- Thompson RG Pearson L Schoenfeld SL 1998 Pramlintide, a synthetic analog of human amylin, improves the metabolic profile of patients with type 2 diabetes using insulin. The Pramlintide in Type 2 Diabetes Group Diabetes Care 21 987 93 9614619
- Thompson RG Peterson J Gottlieb A 1997c Effects of pramlintide, an analog of human amylin, on plasma glucose profiles in patients with IDDM: results of a multicenter trial Diabetes 46 632 6 9075803
- United Kingdom Proscpective Diabetes Study Group 1998a Effect of intensive blood glucose control with metformin on complications in overweight patients with type 2 (UKPDS 34) Lancet 352 854 65 9742977
- United Kingdom Proscpective Diabetes Study Group 1998b Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) Lancet 352 837 53 9742976
- Weyer C Fineman M Strobel S 2005 Properties of pramlintide and insulin upon mixing Am J Health-Syst Pharm 62 816 22 15821274
- Weyer C Gottlieb A Kim DD 2003 Pramlintide reduces postprandial glucose excursions when added to regular insulin or insulin lispro in subjects with type 1 diabetes: a dose-timing study Diabetes Care 26 3074 9 14578242
- Weyer C Maggs DG Young AA 2001 Amylin replacement with pramlintide as an adjunct to insulin therapy in type 1 and type 2 diabetes mellitus: a physiological approach toward improved metabolic control.[erratum appears in Curr Pharm Des 2001 Dec; 7(18):1967] Curr Pharm Des 7 1353 73 11472273
- Wysham C Lush C Zhang B 2008 Effect of pramlintide as an adjunct to basal insulin on markers of cardiovascular risk in patients with type 2 diabetes Curr Med Res Opin 24 79 85 18031595
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- Authors
- Ryan, G., Jobe, L., & Briscoe, T.
- Affiliations
- Mercer University (US)
- Corresponding author
- Ryan, Gina
- Venue
- Drug Design, Development and Therapy
- Publisher
- Informa UK Limited
- Published
- 2008-10
- Volume
- 2
- Pages
- 203
- ISSN
- 1177-8881 (ISSN-L)
- PMC
- PMC2761191
- OpenAlex
- W2008730189
- Cited by
- 98
- References
- 8
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 2 · 2023: 5 · 2022: 9 · 2021: 7 · 2020: 9 · 2019: 7 · 2018: 7 · 2017: 7 · 2016: 5 · 2015: 2 · 2014: 3 · 2013: 6 · 2012: 4
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Drug Design Development and Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- pramlintide, amylin analogues, type 1 diabetes, type 2 diabetes, adjunctive therapy, glycemic control, HbA1c reduction, postprandial blood glucose, glucagon suppression, gastric emptying, weight loss, hypoglycemia, nausea, drug interactions, pharmacokinetics
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