Insulin's Partner: Amylin

| Jan 28, 2011

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.

Sources: 

DiabetesNet.com

Juvenation.org

 

 

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Categories: Blood Sugar, Diabetes, Diabetes, Food, Insulin, Losing weight, Medications, Symlin, Type 1 Issues, Type 2 Issues


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Comments

Posted by helins19 on 6 May 2011

I just started symlin four weeks ago and I am very pleased with it.(I am type 1 about 35 years and on pump and CGMS. My HbA1c is 6.6 and I can't believe I can't get it lower with the CGMS etc. The fact is there are peaks when you open your mouth and eat something. It takes even the fast insulin two hours to work. I use Novolog. I have gotten into the habit of bolusing every time my alert says I am going high (above 140) and that has led to some lows because often it is just time for the IOB to act. I am not overweight but have noticed a few pounds I can't get off and I am always hungry.)
I had to plead with my doctor for a prescription for symlin because he said "I am in good control and not overweight etc". I promised him I knew what I was doing.
I am now using 45 mcg of symlin three times a day. I take about 1/2 to 3/4 of my regular insulin. The BG does not go up at all after eating which I find amazing. It does go up 2 hours later for me. At that time I can see the rise on the CGMS and give the rest of my normal insulin. I tried the dual wave but went low because there was still too much insulin during the two hour period. It is a learning experience but I don't know why all type 1's aren't using symlin. I would like to hear about the experiences of others using symlin.


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