Effect of pramlintide on postprandial glucose fluxes in type 1 diabetes

Ling Hinshaw, Michele Schiavon, Vikash Dadlani, Ashwini Mallad, Chiara Dalla Man, Adil Eddie Bharucha, Rita Basu, Jennifer R. Geske, Rickey E. Carter, Claudio Cobelli, Ananda Basu, Yogish C Kudva

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Context: Early postprandial hyperglycemia and delayed hypoglycemia remain major problems in current management of type 1 diabetes (T1D). Objective: Our objective was to investigate the effects of pramlintide, known to suppress glucagon and delay gastric emptying, on postprandial glucose fluxes in T1D. Design: This was a single-center, inpatient, randomized, crossover study. Patients: Twelve patients with T1D who completed the study were analyzed. Interventions: Subjects were studied on two occasions with or without pramlintide. Triple tracer mixed-meal method and oral minimal model were used to estimate postprandial glucose turnover and insulin sensitivity (SI). Integrated liver insulin sensitivity was calculated based on glucose turnover. Plasma glucagon and insulin were measured. Main Outcome Measure: Glucose turnover and SI were the main outcome measures. Results: With pramlintide, 2-hour postprandial glucose, insulin, glucagon, glucose turnover, and SI indices showed: plasma glucose excursions were reduced (difference in incremental area under the curve [iAUC], 444.0 mMmin, P = .0003); plasma insulin concentrations were lower (difference in iAUC, 7642.0 pMmin; P = .0099); plasma glucagon excursions were lower (difference in iAUC, 1730.6 pg/mlmin; P=.0147); meal rate of glucose appearance was lower (difference in iAUC: 1196.2 μM/kg fat free mass [FFM]; P = .0316), endogenous glucose production was not different (difference in iAUC: -105.5 μM/kg FFM; P = .5842), rate of glucose disappearance was lower (difference in iAUC: 1494.2 μM/kg FFM; P = .0083). SI and liver insulin sensitivity were not different between study visits (P > .05). Conclusions: Inhibition of glucagon and gastric emptying delaying reduced 2-hour prandial glucose excursions in T1D by delaying meal rate of glucose appearance.

Original languageEnglish (US)
Pages (from-to)1954-1962
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume101
Issue number5
DOIs
StatePublished - May 1 2016

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Medical problems
Type 1 Diabetes Mellitus
Fluxes
Glucose
Area Under Curve
Glucagon
Insulin
Meals
Plasmas
Insulin Resistance
Gastric Emptying
Fats
Liver
pramlintide
Outcome Assessment (Health Care)
Hypoglycemia
Hyperglycemia
Cross-Over Studies
Inpatients

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Effect of pramlintide on postprandial glucose fluxes in type 1 diabetes. / Hinshaw, Ling; Schiavon, Michele; Dadlani, Vikash; Mallad, Ashwini; Dalla Man, Chiara; Bharucha, Adil Eddie; Basu, Rita; Geske, Jennifer R.; Carter, Rickey E.; Cobelli, Claudio; Basu, Ananda; Kudva, Yogish C.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 101, No. 5, 01.05.2016, p. 1954-1962.

Research output: Contribution to journalArticle

Hinshaw, L, Schiavon, M, Dadlani, V, Mallad, A, Dalla Man, C, Bharucha, AE, Basu, R, Geske, JR, Carter, RE, Cobelli, C, Basu, A & Kudva, YC 2016, 'Effect of pramlintide on postprandial glucose fluxes in type 1 diabetes', Journal of Clinical Endocrinology and Metabolism, vol. 101, no. 5, pp. 1954-1962. https://doi.org/10.1210/jc.2015-3952
Hinshaw, Ling ; Schiavon, Michele ; Dadlani, Vikash ; Mallad, Ashwini ; Dalla Man, Chiara ; Bharucha, Adil Eddie ; Basu, Rita ; Geske, Jennifer R. ; Carter, Rickey E. ; Cobelli, Claudio ; Basu, Ananda ; Kudva, Yogish C. / Effect of pramlintide on postprandial glucose fluxes in type 1 diabetes. In: Journal of Clinical Endocrinology and Metabolism. 2016 ; Vol. 101, No. 5. pp. 1954-1962.
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AU - Dalla Man, Chiara

AU - Bharucha, Adil Eddie

AU - Basu, Rita

AU - Geske, Jennifer R.

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