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

• DOI: 10.2337/dc18-1091
• Publication Date: 2018-09-13T16:15:18Z
• Authors: Matthew C. Riddle; Rajaa Nahra; Jenny Han; Jessica Castle; Kathryn Hanavan; Marcus Hompesch; David Huffman; Poul Strange; Peter Öhman
• Keywords: Amylin; Crossover study

OBJECTIVE Healthy pancreatic β-cells secrete the hormones insulin and amylin in a fixed ratio. Both are lacking type 1 diabetes, postprandial glucose control using therapy alone is difficult. This study tested pharmacodynamic effects of analog pramlintide delivered ratio over 24-h period. RESEARCH DESIGN AND METHODS Patients with diabetes were stabilized on pump lispro before randomized, single-masked, two-way crossover, inpatient which regular human was administered or placebo separate infusion pumps (9 μg/unit). Meal content timing patient-specific doses same each treatment. The primary outcome measure change mean by continuous monitoring (CGM). Profiles laboratory-measured glucose, insulin, glucagon, triglycerides also compared. RESULTS Mean measured CGM lower versus (8.5 vs. 9.7 mmol/L, respectively; P = 0.012) due to marked reduction increments. Glycemic variability reduced, glucagon placebo. Gastrointestinal side more frequent during use pramlintide; no major hypoglycemic events occurred CONCLUSIONS Coadministration fixed-ratio for 24 h improved hyperglycemia glycemic patients diabetes. Longer studies including dose titration under daily conditions needed determine whether this regimen could provide long-term improvement control.