Infusion of pramlintide, a human amylin analogue, delays gastric emptying in men with IDDM

Jan 1, 1997Diabetologia

Pramlintide, a human amylin-like drug, slows stomach emptying in men with insulin-dependent diabetes

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Abstract

Pramlintide significantly delayed gastric emptying of liquid and solid meal components compared to placebo.

The median lag time for liquid gastric emptying was 69 minutes with pramlintide versus 7.5 minutes with placebo.
The median lag time for solid gastric emptying was 150 minutes with pramlintide compared to 44.5 minutes with placebo.
Pramlintide's effect was so pronounced that t50 values for gastric emptying could not be calculated for either meal component.
These findings suggest that pramlintide may improve glycaemic control in insulin-dependent diabetes mellitus by altering gastric emptying.

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Pramlintide, a human amylin analogue, reduces hyperglycaemia after meals in patients with insulin-dependent diabetes mellitus (IDDM). We investigated whether this was due to delayed gastric emptying. Eight men with uncomplicated IDDM were studied twice in a randomised, double-blind crossover design. Euglycaemia was maintained overnight by intravenous infusion of glucose and/or insulin and the following morning a 5-h infusion of pramlintide 25 micrograms/h or placebo was started at 08.00 hours. At 08.30 hours the patients injected their normal morning insulin dose subcutaneously and 30 min later ate a meal (600 kcal, 50% carbohydrate) of which the solid component was labelled with Technetium-99 m and the liquid with Indium-111 to quantify gastric emptying. Gamma-scintigraphic images were obtained every 20 min for the next 4 h. Insulin and glucose were infused as necessary to maintain blood glucose levels within 3 mmol/l of the pre-meal value. Compared to placebo, pramlintide significantly delayed emptying of both liquid (median lag time 69 vs 7.5 min) and solid (median lag time 150 vs 44.5 min) components of the meal. Pramlintide delayed gastric emptying so much that t50 values could not be calculated for solid or liquid. Amylin agonists such as pramlintide may, therefore, be of value in improving glycaemic control in IDDM by modifying gastric emptying.

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Infusion of pramlintide, a human amylin analogue, delays gastric emptying in men with IDDM

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