Generality
Amylin is a peptide hormone synthesized by pancreatic β cells together with insulin, and co-secreted to it in response to meals and hyperglycemic conditions.
Like insulin, amylin is particularly active on glucose metabolism, so much so that a synthetic analogue of it (pramlintide) has been authorized by the FDA as a medicine for the treatment of diabetes mellitus (trade name Symlin ®), both type I and type II, in synergy with insulin.
Just like drugs containing insulin, pramlintide must be administered by subcutaneous injection, since once ingested it would be completely inactivated, as is the case with food-borne proteins.
Therapeutic Effects
Amylin and pramlintide have been shown to:
- slow gastric emptying
- decrease digestive secretions (bile, gastric, enteric and pancreatic juices)
- reduce plasma glucagon, a catabolic hormone with hyperglycemic effects
- increase the sense of satiety
- overall, reduce post-prandial glycaemia, improving the control of this important risk factor for the complications of diabetes mellitus.
Side effects
The side effects of amylin analogues are related to slowed gastric emptying, with possible onset of nausea and vomiting. The potential ability to promote body weight, given the central anorectic effects, make amylin derivatives particularly useful. in obese diabetics.
Excess of Amylin as a Cause of Diabetes
Human amylin contains an amyloidogenic peptide sequence, which predisposes it to precipitate forming amyloid, especially when produced and secreted in excess. It is therefore hypothesized that insulin and amylin hypersecretion - which occurs as a compensatory response of pancreatic β cells to insulin resistance - is involved in pancreatic cell damage that opens the doors to type II diabetes mellitus.
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