How Do Antidiabetic Amylinomimetics Work?

Amylinomimetics are a class of drugs used to treat type 1 and type 2 diabetes (T1DM and T2DM). They are used to treat patients for whom blood sugar could not be controlled by insulin alone or insulin along with oral medications. T1DM (also known as juvenile or insulin-dependent diabetes) is an autoimmune disorder in which the body is unable to process glucose because of lack of insulin and the immune system attacks and destroys cells in the pancreas that produce insulin. T2DM is a condition in which the cells cannot use blood sugar efficiently to meet the body’s needs. Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems.

The only drug that belongs to this class is “pramlintide,” an analog of amylin, a small peptide hormone that is released into the bloodstream by the β cells of the pancreas along with insulin after a meal. Amylin assists insulin in postprandial glucose control. Similar to insulin, amylin is completely absent in individuals with T1DM.

Pramlintide (man-made hormone) is administered as a solution (liquid) in a prefilled dosing pen to inject subcutaneously (just under the skin). It is usually injected several times a day before each meal that includes at least 250 calories or 30 grams of carbohydrates.

Amylinomimetics work in the following ways:

• Pramlintide belongs to a class of medications called “antihyperglycemics.”
• It works by slowing the movement of food through the stomach, which prevents blood sugar from rising too high after a meal.
• Pramlintide is a synthetic hormone that resembles human amylin.
• Amylin controls the blood sugar level by slowing down the rate at which food (including glucose) is absorbed from the intestine.
• It reduces the production of glucose by the liver by inhibiting the action of glucagon, a hormone produced by the pancreas that stimulates the production of glucose by the liver.
• In addition, it promotes satiety, thus suppressing the intake of food.

Pramlintide is used together with insulin to treat T1DM or T2DM. It allows patients to use less insulin, lowers average blood sugar levels, and substantially reduces the unhealthy rise in blood sugar that occurs in patients with diabetes immediately after eating.

Taking medications, making lifestyle changes (e.g., diet, exercise, and quitting smoking), and regularly checking blood sugar may help to manage diabetes and improve health.

Some of the common side effects include:

• Nausea
• Vomiting
• Headache
• Anorexia (loss of appetite)
• Fatigue (overall feeling of tiredness or lack of energy)
• Abdominal pain
• Redness, swelling, bruising, or itching at the injection site

Other rare side effects include:

• Severe hypoglycemia (excessively low blood glucose)
• Dizziness (feeling faint, weak, or unsteady)
• Cough
• Arthralgia (pain in joints)
• Weight loss
• Pharyngitis (inflammation of the pharynx)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of antidiabetic amylinomimetics include:

• Pramlintide
• Symlin
• SymlinPen 120
• SymlinPen 60