Pramlintide, the synthetic analogue of amylin: physiology, pathophysiology, and effects on glycemic control, body weight, and selected biomarkers of vascular risk

Byron J Hoogwerf; Krupa B Doshi; Dima Diab

doi:10.2147/vhrm.s1978

Pramlintide, the synthetic analogue of amylin: physiology, pathophysiology, and effects on glycemic control, body weight, and selected biomarkers of vascular risk

Vasc Health Risk Manag. 2008;4(2):355-62. doi: 10.2147/vhrm.s1978.

Authors

Byron J Hoogwerf¹, Krupa B Doshi, Dima Diab

Affiliation

¹ Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic Foundation, Cleveland, USA. hoogweb@ccf.org

Abstract

Pramlintide is a synthetic version of the naturally occurring pancreatic peptide called amylin. Amylin and pramlintide have similar effects on lowering postprandial glucose, lowering postprandial glucagon and delaying gastric emptying. Pramlintide use in type 1 and insulin requiring type 2 diabetes mellitus (DM) is associated with modest reductions in HbAlc often accompanied by weight loss. Limited data show a neutral effect on blood pressure. Small studies suggest small reductions in LDL-cholesterol in type 2 DM and modest reductions in triglycerides in type 1 DM. Markers of oxidation are also reduced in conjunction with reductions in postprandial glucose. Nausea is the most common side effect. These data indicate that pramlintide has a role in glycemic control of both type 1 and type 2 DM. Pramlintide use is associated with favorable effects on weight, lipids and other biomarkers for atherosclerotic disease.

Publication types

Review

MeSH terms

Amyloid / metabolism
Amyloid / pharmacology
Amyloid / therapeutic use*
Biomarkers / blood*
Blood Glucose / drug effects*
Blood Pressure / drug effects
Body Weight / drug effects*
Cardiovascular Diseases / blood
Cardiovascular Diseases / etiology
Cardiovascular Diseases / physiopathology
Cardiovascular Diseases / prevention & control*
Cholesterol, LDL / blood
Diabetes Mellitus, Type 1 / blood
Diabetes Mellitus, Type 1 / complications
Diabetes Mellitus, Type 1 / drug therapy*
Diabetes Mellitus, Type 1 / physiopathology
Diabetes Mellitus, Type 2 / blood
Diabetes Mellitus, Type 2 / complications
Diabetes Mellitus, Type 2 / drug therapy*
Diabetes Mellitus, Type 2 / physiopathology
Glycated Hemoglobin / metabolism
Humans
Hypoglycemic Agents / pharmacology
Hypoglycemic Agents / therapeutic use*
Islet Amyloid Polypeptide
Oxidative Stress / drug effects
Treatment Outcome
Triglycerides / blood

Substances

Amyloid
Biomarkers
Blood Glucose
Cholesterol, LDL
Glycated Hemoglobin A
Hypoglycemic Agents
Islet Amyloid Polypeptide
Triglycerides
hemoglobin A1c protein, human
pramlintide