New research shows improved mealtime glucose levels when recapitulating non-diabetes like physiology

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When people without diabetes eat meals, the pancreas naturally secretes insulin and another hormone, amylin. For people with diabetes, a synthetic version of amylin, called pramlintide, can be used to manage blood-sugar levels in addition to mealtime insulin. Pramlintide is typically prescribed for individuals who have difficulty managing their blood sugar at mealtimes with insulin alone.

A recent study in the journal Diabetes Care tested the effects of delivering both insulin and pramlintide over a 24-hour period. In the study, people with type 1 diabetes (T1D) received insulin through an insulin pump at mealtimes, and simultaneously received pramlintide through a separate pump, thus mimicking the non-diabetes like physiology. Each participant’s meals and insulin doses were identical and researchers looked at the overall change in blood glucose levels, as measured by continuous glucose monitoring (CGM).

The study found that participants’ average 24-hour and post meal glucose levels were lower when pramlintide was delivered with insulin, in comparison with insulin alone. There were more gastrointestinal side effects for those who received pramlintide in some individuals, but no major hypoglycemic events occurred.

“The present findings…provide further support for the potential of the continuous fixed-dose combination of pramlintide and insulin to improve glycemic control in patients with type 1 diabetes,” the study says.

Compared with insulin alone, the combination of insulin and pramlintide significantly reduced overall variability in blood glucose levels occurring after a meal, as well as increased time in range. This observation extends prior studies of this T1D management approach, although researchers noted that longer studies are needed to determine whether using pramlintide in conjunction with insulin could help with long-term control of blood glucose.

JDRF was key in making this clinical trial happen. We funded an Industry Discovery and Development Program (IDDP) grant to AstraZeneca in 2011, with the goal of identifying a co-formulation of pramlintide and insulin that could be given at the same time. The clinical study (trial number NCT01708044), as well as another study (trial number NCT02500979) that JDRF funded, ran from 2012 to 2016.

To learn more about glucose control and related JDRF research, click here.