Pramlintide Reduces the Risks Associated with Glucose Variability in Type 1 Diabetes

Abstract Background: This study was designed to determine whether pramlintide added to insulin therapy reduced the risks associated with extreme blood glucose (BG) fluctuations in patients with type 1 diabetes. Methods: Self-monitored BG (SMBG) records were retrospectively analyzed from a randomized, double-blind, placebo-controlled study of the effects of pramlintide on intensively treated patients with type 1 diabetes. Two groups—pramlintide (n = 119), 30/60 μg administered subcutaneously at each meal, or placebo (n = 129)—were matched by age, gender, and baseline hemoglobin A1C. Using SMBG, daily BG profiles, BG rate of change, and low and high BG indices (LBGI and HBGI, respectively) measuring the risk for hypoglycemia and hyperglycemia were calculated. Results: Compared with placebo, pramlintide significantly attenuated the pre- to postprandial BG rate of change (F = 83.8, P < 0.0001). Consequently, in pramlintide-treated patients, the average post-meal BG (8.4 vs. 9.7 mmol/L [151.2 vs. 174.6 mg/dL])...