An adult neighbor who was diagnosed with Type 1 diabetes 53 years ago, is participating in a study using amylin. I believe he said it was an enzyme produced by everyone except Type 1 diabetics.
Can you give us any information about amylin and about the clinical trials now underway with amylin?
Amylin, or Islet Amyloid Polypeptide, is a newly discovered hormone that is about the same size as insulin, and is co-secreted in response to a rise in blood glucose. Its primary metabolic effects seem to be to modulate glucose absorption from the bowel to match the rate at which it is disposed of in the rest of the body, and to conserve liver glycogen at the expense of muscle glycogen.
It would appear to have two roles in relation to diabetes. In Type 2 diabetes, there is some evidence both from animals and man that certain forms of amylin may coalesce into fibrils and that this is associated with damage to the beta cell and ultimately to insulin production. In Type 1 diabetes, the kind your friend has, the supply of amylin diminishes at the same time as that of insulin, with the gradual immunological destruction of the beta cell.
Amylin Pharmaceuticals, Inc. (in San Diego, California) have made an analogue of human amylin under the name of pramlintide and they are promoting clinical trials in Type 1 diabetes. Studies so far have shown that subcutaneous injection of the hormone shortly before consumption of a Sustacal load does indeed flatten the glucose tolerance curve. Whether this new drug will make a cost-effective contribution to long term control remains to be seen.
Original posting 28 Oct 96
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