Pramlintide improves blood sugar levels diabetics
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Pramlintide treatment, taken with insulin, improves blood sugar fluctuations after meals and also reduces weight in patients with type 1 diabetes, according to a report in the Diabetes Care.
Pramlintide, sold in the United States under the trade name Symlin, helps regulate blood-sugar levels by slowing down gastric emptying, suppressing glucagon secretion and reducing food intake, the authors explain.
Dr. Orville Kolterman from Amylin Pharmaceuticals, San Diego, California and colleagues assessed the safety, efficacy, and tolerability of pramlintide in 296 patients with type 1 diabetes. Also referred to as juvenile diabetes, type 1 diabetes results from the inability of the pancreas to make enough insulin to process levels of sugar in the blood.
The patients were randomly assigned to receive pramlintide or placebo, along with insulin. Pramlintide doses were escalated at mealtime while insulin doses were reduced by 30 percent to 50 percent. Thereafter, insulin was adjusted to optimize sugar control.
After 29 weeks of treatment, the number of blood sugar fluctuations after meals was significantly reduced in the pramlintide group, but not in the placebo group, the researchers report.
Patients in the pramlintide group were able to lower their total daily insulin dose by about 12 percent, whereas patients in the placebo group experienced little change in their total daily insulin dose.
Pramlintide-treated patients also lost an average of about 3 pounds, the researchers note, but placebo-treated patients gained an average of 3 pounds.
Nausea was more prevalent among pramlintide-treated patients, the report indicates, but low blood sugar occurred with similar frequency in the pramlintide and placebo groups.
Dose escalation of pramlintide combined with dose reduction of insulin at mealtime “provides an effective method for introducing pramlintide into the treatment regimen of intensively treated patients with type 1 diabetes,” Kolterman and colleagues conclude. The strategy of adding pramlintide, followed by optimizing the insulin dosage, achieved better results than treatment with insulin alone.
SOURCE: Diabetes Care, October 2006.
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