Fixed ratio dosing of pramlintide with regular insulin before a standard meal in patients with type 1 diabetes

M. C. Riddle, K. C J Yuen, T. W. de Bruin, K. Herrmann, J. Xu, P. Öhman, O. G. Kolterman

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Amylin is co-secreted with insulin and is therefore lacking in patients with type 1 diabetes. Replacement with fixed ratio co-administration of insulin and the amylin analogue pramlintide may be superior to separate dosing. This concept was evaluated in a ratio-finding study. Patients with type 1 diabetes were enrolled in a randomized, single-masked, standard breakfast crossover study using regular human insulin injected simultaneously with pramlintide 6, 9 or 12 mcg/unit insulin or placebo. Insulin dosage was reduced by 30% from patients' usual estimates. Plasma glucose, glucagon and pramlintide and adverse events were assessed. All ratios reduced 0-3-h glucose and glucagon increments by >50%. No hypoglycaemia occurred. Adverse events were infrequent and generally mild. All pramlintide/insulin ratios markedly and safely reduced glycaemic excursions and suppressed glucagon secretion in the immediate postprandial state. Further study using one of these ratios to explore the efficacy and safety of longer-term meal-time and basal hormone replacement is warranted.

Original languageEnglish (US)
Pages (from-to)904-907
Number of pages4
JournalDiabetes, Obesity and Metabolism
Volume17
Issue number9
DOIs
Publication statusPublished - Sep 1 2015
Externally publishedYes

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Keywords

  • Amylin
  • Pramlintide
  • Type 1 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Riddle, M. C., Yuen, K. C. J., de Bruin, T. W., Herrmann, K., Xu, J., Öhman, P., & Kolterman, O. G. (2015). Fixed ratio dosing of pramlintide with regular insulin before a standard meal in patients with type 1 diabetes. Diabetes, Obesity and Metabolism, 17(9), 904-907. https://doi.org/10.1111/dom.12504