Pramlintide

Pramlintide (Symlin) is a synthetic analog of amylin, FDA-approved as an adjunct to insulin therapy in type 1 and type 2 diabetes. It helps control post-meal blood sugar spikes and promotes modest weight loss.

Mechanism of Action

Mimics amylin's effects: slows gastric emptying, suppresses glucagon secretion after meals, and promotes satiety through central mechanisms. Complements insulin therapy.

Typical Dosage (Research)

Type 1: Start 15mcg before meals, titrate to 30-60mcg. Type 2: Start 60mcg, may increase to 120mcg. Always with meal containing 30+ grams carbs or 250+ calories.

Subcutaneous injection immediately before major meals. Must reduce mealtime insulin by 50% when starting to prevent hypoglycemia. Never mix with insulin.

Side Effects & Risks

Nausea (very common initially), headache, anorexia, vomiting, and abdominal pain. GI effects typically improve over time.

Severe hypoglycemia risk, especially in type 1 diabetes. Boxed warning about insulin-induced severe hypoglycemia. Requires careful dose management.

Who Uses Pramlintide

Diabetics on insulin seeking better post-meal control, those not achieving goals with insulin alone, patients wanting modest weight loss support.