The role of prandial pramlintide in the treatment of adolescents with type 1 diabetes

Luisa M. Rodriguez, Kimberly J. Mason, Morey W. Haymond, Rubina A. Heptulla

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Pramlintide, a synthetic analog of amylin, improves postprandial hyperglycemia. We compared subcutaneous (s.c.) pramlintide injection with square wave pramlintide infusion in adolescents with type 1 diabetes (T1DM). Eight subjects with T1DM underwent two randomized studies. Subcutaneous pramlintide (dose = 5 μg/unit of insulin) bolus, was given one time and another time, the same dose was given as a 120-min s.c. infusion. Insulin dose was constant between studies. Gastric emptying was assessed with oral acetaminophen and [l-C]glucose in meal. Plasma glucagon, pramlintide, and insulin concentrations were measured. Insulin concentrations (p < 0.99) between pramlintide injection versus infusion were similar; however, glucose concentrations were different (p < 0.0001), with the absence of hypoglycemia during pramlintide infusion [AUC (0-120 min) -0.07 ± 0.2 versus 1.05 ± 0.24 mg * h/dL (p < 0.0088)]. Insulin-only administration resulted in postprandial hyperglycemia and late postprandial hypoglycemia (p < 0.0001). Two subjects experienced hypoglycemia with pramlintide injection. Pramlintide bolus caused pronounced glucagon suppression (p < 0.0003) and delayed gastric emptying as ([CO2] p < 0.0003 and acetaminophen p < 0.01) compared with infusion. We conclude that pramlintide bolus may result in an increase in risk of immediate postprandial hypoglycemia. Further modifications in pramlintide delivery are indicated before it can be safely used in children.

Original languageEnglish (US)
Pages (from-to)746-749
Number of pages4
JournalPediatric Research
Volume62
Issue number6
DOIs
StatePublished - Dec 2007
Externally publishedYes

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Type 1 Diabetes Mellitus
Meals
Hypoglycemia
Insulin
Therapeutics
Gastric Emptying
Acetaminophen
Glucagon
Hyperglycemia
pramlintide
Islet Amyloid Polypeptide
Subcutaneous Infusions
Glucose
Injections
Subcutaneous Injections
Area Under Curve

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

The role of prandial pramlintide in the treatment of adolescents with type 1 diabetes. / Rodriguez, Luisa M.; Mason, Kimberly J.; Haymond, Morey W.; Heptulla, Rubina A.

In: Pediatric Research, Vol. 62, No. 6, 12.2007, p. 746-749.

Research output: Contribution to journalArticle

Rodriguez, Luisa M. ; Mason, Kimberly J. ; Haymond, Morey W. ; Heptulla, Rubina A. / The role of prandial pramlintide in the treatment of adolescents with type 1 diabetes. In: Pediatric Research. 2007 ; Vol. 62, No. 6. pp. 746-749.
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