Insulin's Partner: Amylin
Insulin has a companion, and it's called amylin. Amylin is a small hormone that is released along with insulin by the beta cells of the pancreas in response to a meal. When people are insulin-deficient, they are amylin-deficient as well. Amylin wasn't even discovered until 1970, and it was not until the 1990s that scientists began to figure out what amylin does. But they now know that it partners with insulin to help control blood sugar levels, each in its own way:
Insulin controls how much sugar gets out of your blood and into the muscles and tissues in your body. Without enough insulin, too much sugar remains in the blood
Amylin helps control how much sugar gets into your blood after a meal, and how quickly it gets there. Amylin keeps too much glucose from appearing in the blood in the first place.
Amylin accomplishes this in a number of ways. It decreases appetite by promoting a feeling of fullness, thereby reducing food intake. It slows gastric emptying and inhibits the secretion of digestive enzymes, all of which slow the appearance of glucose in the blood after a meal. It also inhibits the secretion of glucagon, which otherwise causes additional glucose release by the liver at mealtimes.
In short, the release of amylin minimizes the glucose spikes that often occur after meals in insulin-dependent diabetes. A smaller glucose spike means that less insulin is needed to manage post-meal glucose.
Symlin (pramlintide acetate) is a longer-acting analog, or form, of amylin that was created by Amylin Pharmaceuticals. The man-made form of amylin does all the good work that natural amylin does, decreasing the rate of gastric emptying, increasing satiety, lowering after-meal glucagon secretion, and controlling after-meal glucose spikes. People on Symlin tend to need less insulin for meals, and they also tend to lose weight. It was approved by the FDA in 2005 for injection by people with type 1 diabetes and insulin-using people with type 2
Amylin Pharmaceuticals, which manufactures Symlin, recently placed a microsite on the Resources section of juvenation.org (the online social network community of the Juvenile Diabetes Research Foundation).The microsite is intended to educate people with type 1 diabetes about the role that Symlin injection can play in diabetes management and provide an online forum for people to exchange stories and share personal insights about using Symlin. The Symlin microsite is available at http://juvenation.org/groups/is_mealtime_insulin_enough/default4.aspx.
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