Physiology of amylin in glucose metabolism
Amylin, a pancreatic peptide hormone, contributes significantly to the regulation of glucose metabolism. Upon food ingestion, amylin is co-secreted with insulin from the beta cells of the pancreas. The hormone functions to decelerate gastric emptying and suppress postprandial glucagon postprandially, leading to a decrease in glucose release from the liver. This process helps in the control of postprandial hyperglycemia.
Amylin analogs, exemplified by pramlintide, emulate the actions of natural amylin, a hormone co-secreted with insulin by pancreatic beta cells. These analogs have been engineered to mimic amylin’s effects in glucose metabolism regulation.
Mechanism of action of amylin analogs or mimetics
Acting similarly to endogenous amylin, pramlintide modulates the pace of food digestion, leading to postponed absorption of glucose into the bloodstream. Pramlintide also restricts postprandial secretion of glucagon, helping to reduce glucose production by the liver. Furthermore, pramlintide exerts its influence on the center of satiety in the brain, leading to suppression of appetite. This effect can result in a reduction in food intake and body weight.
Practice Guide
Pramlintide is typically administered subcutaneously before meals. After administration, the drug is quickly absorbed, achieving its peak effect within 30 minutes. The duration of pramlintide action extends to approximately 3-4 hours, making it suitable for administration prior to each meal. This dosing schedule aligns well with its ability to control postprandial glucose levels, potentially leading to better overall glycemic control.
References
- McQueen J (2005) Pramlintide acetate. Am J Health-Syst Pharm AJHP Off J Am Soc Health-Syst Pharm 62:2363–2372
- Ramkissoon CM, Aufderheide B, Bequette BW, Palerm CC (2014) A model of glucose-insulin-pramlintide pharmacokinetics and pharmacodynamics in type I diabetes. J Diabetes Sci Technol 8:529–542
- Whitehouse F, Kruger DF, Fineman M, Shen L, Ruggles JA, Maggs DG, Weyer C, Kolterman OG (2002) A randomized study and open-label extension evaluating the long-term efficacy of pramlintide as an adjunct to insulin therapy in type 1 diabetes. Diabetes Care 25:724–730
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