Control of Postprandial Hyperglycemia in Type 1 Diabetes by 24-Hour Fixed-Dose Coadministration of Pramlintide and Regular Human Insulin: A Randomized, Two-Way Crossover Study

Diabetes Care
M C RiddleP Öhman

Abstract

Healthy pancreatic β-cells secrete the hormones insulin and amylin in a fixed ratio. Both hormones are lacking in type 1 diabetes, and postprandial glucose control using insulin therapy alone is difficult. This study tested the pharmacodynamic effects of the amylin analog pramlintide and insulin delivered in a fixed ratio over a 24-h period. Patients with type 1 diabetes were stabilized on insulin pump therapy with insulin lispro before a randomized, single-masked, two-way crossover, 24-h inpatient study in which regular human insulin was administered with pramlintide or placebo using separate infusion pumps in a fixed ratio (9 μg/unit). Meal content and timing and patient-specific insulin doses were the same with each treatment. The primary outcome measure was change in mean glucose by continuous glucose monitoring (CGM). Profiles of laboratory-measured glucose, insulin, glucagon, and triglycerides were also compared. Mean 24-h glucose measured by CGM was lower with pramlintide versus placebo (8.5 vs. 9.7 mmol/L, respectively; P = 0.012) due to a marked reduction of postprandial increments. Glycemic variability was reduced, and postprandial glucagon and triglycerides were also lower with pramlintide versus placebo. Gastrointes...Continue Reading

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Citations

Feb 6, 2019·Current Opinion in Endocrinology, Diabetes, and Obesity·Halis Kaan Akturk, Satish Garg
Jan 4, 2020·Diabetologia·Amy S Shah, Kristen J Nadeau
Feb 19, 2020·Diabetes Technology & Therapeutics·Melanie Jackson, Jessica R Castle
Feb 19, 2020·Diabetes Technology & Therapeutics·Satish K GargIrl B Hirsch
Mar 21, 2019·Expert Review of Clinical Pharmacology·Laura M NallyWilliam V Tamborlane
May 20, 2020·Clinical Medicine Insights. Endocrinology and Diabetes·Andrew English, Nigel Irwin
Jul 4, 2020·Current Opinion in Endocrinology, Diabetes, and Obesity·Anna CasuUNKNOWN Advancing Care for Type 1 Diabetes, Obesity Network (ACT1ON)
Jan 29, 2021·Science Translational Medicine·Caitlin L MaikawaEric A Appel
Feb 18, 2021·Diabetologia·Bernt Johan von ScholtenMatthias von Herrath
Apr 19, 2021·Diabetes Research and Clinical Practice·Matthew C Riddle
May 26, 2021·Journal of Diabetes Science and Technology·Claudio Cobelli, Chiara Dalla Man
Jul 29, 2021·Journal of Diabetes Science and Technology·Shylaja SrinivasanEda Cengiz
Aug 28, 2021·Current Diabetes Reports·I H TeohJ D Schofield
Aug 25, 2021·Molecular Metabolism·Mark A JarosinskiMichael A Weiss
Dec 2, 2021·The Journal of Clinical Endocrinology and Metabolism·Mark A JarosinskiMichael A Weiss

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