title: Pramlintide, a synthetic analog of human amylin, improves the metabolic profile of patients with type 2 diabetes using insulin. The Pramlintide in Type 2 Diabetes Group.
abstract: OBJECTIVE
  To examine the effects of 4 weeks of subcutaneous administration of pramlintide, a synthetic analog of human amylin, on metabolic control in patients with type 2 diabetes using insulin.
  
  
  METHODS
  Serum fructosamine, HbA1c, and fasting plasma lipids were measured in 203 patients in a randomized double-blind placebo-controlled parallel-group multicenter trial using doses of 30 micrograms q.i.d., 60 micrograms t.i.d., and 60 micrograms q.i.d.
  
  
  RESULTS
  Statistically significant reductions in serum fructosamine concentrations were observed in the pramlintide 30 micrograms q.i.d. group (17.5 +/- 4.9 mumol/l, P = 0.029), the pramlintide 60 micrograms t.i.d. group (24.1 +/- 4.9 mumol/l, P = 0.003), and the 60 micrograms q.i.d. group (22.6 +/- 4.1 mumol/l, P = 0.001) compared with the placebo group (3.5 +/- 3.8 mumol/l). There were also statistically significant shifts in the proportion of patients with an abnormal serum fructosamine concentration at baseline that normalized at week 4 within the pramlintide 60 micrograms t.i.d. group and the 60 micrograms q.i.d. group. Consistent with the fructosamine results, there were statistically significant reductions in HbA1c in the pramlintide 30 micrograms q.i.d. group (0.53 +/- 0.07%, P = 0.0447), the pramlintide 60 micrograms t.i.d. group (0.58 +/- 0.07%, P < 0.0217), and the pramlintide 60 micrograms q.i.d. group (0.51 +/- 0.08%, P = 0.0242) compared with the placebo group (0.27 +/- 0.08%). Total cholesterol concentrations were also statistically significantly reduced in both the pramlintide 60 micrograms t.i.d. group (8.4 mg/dl, P < 0.01) and 60 micrograms q.i.d. group (10.5 mg/dl, P < 0.01) compared with placebo (1.2 mg/dl). Body weight decreased in both of the pramlintide 60 micrograms groups, but the trend did not achieve statistical significance. The incidence of hypoglycemia was similar in all treatment groups.
  
  
  CONCLUSIONS
  Reductions in serum fructosamine, plasma total and LDL cholesterol concentrations, and HbA1c support the hypothesis that pramlintide may improve metabolic control in patients with type 2 diabetes using insulin.
authors.affiliation: Amylin Pharmaceuticals, San Diego, California 92121, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Thompson
authors.forename: L
authors.initials: L
authors.lastname: Pearson
authors.forename: S L
authors.initials: SL
authors.lastname: Schoenfeld
authors.forename: O G
authors.initials: OG
authors.lastname: Kolterman
mesh_terms: D000328:Adult; D000368:Aged; D000682:Amyloid / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001835:Body Weight; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D019270:Fructosamine / Q000097:blood*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D058228:Islet Amyloid Polypeptide; D008297:Male; D008875:Middle Aged; D010919:Placebos; D014280:Triglycerides / Q000097:blood
chemical_list: D000682:Amyloid; D015415:Biomarkers; D002784:Cholesterol; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019270:Fructosamine; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D058228:Islet Amyloid Polypeptide; D010919:Placebos; D014280:Triglycerides; C105254:pramlintide