Considering Pramlintide Therapy for Postprandial Blood Glucose Control
- Belinda P. Childs, ARNP, MN, BC-ADM, CDE,
- Nicole C. Kesty, PhD,
- Eric Klein, MD,
- Richard Rubin, PhD, CDE and
- Allison Wick, MSN, ARNP, CDE
- Address correspondence to Belinda P. Childs, ARNP, MN, BC-ADM, CDE, Mid-America Diabetes Associates, PA, 200 S. Hillside, Wichita, KS 67211.
Abstract
Diabetes is a chronic disease affecting > 20 million Americans, and its incidence, especially in the form of type 2 diabetes, is increasing. Multiple therapeutics are available that address the dysregulation of the multiple hormones responsible for glucose homeostasis. Despite the various options, tight glycemic control is often elusive. Additionally, the pursuit of tight glycemic control is generally accompanied by various clinical challenges, such as hypoglycemia, weight gain, and glucose fluctuations, in particular, postprandial fluctuations.
Several therapeutic options are currently available to address postprandial glucose fluctuations, including rapid-acting insulin analogs, incretin mimetics, dipeptidyl peptidase IV inhibitors, α-glucosidase inhibitors, meglitinides, and amylinomimetics. This article presents the experiences of three patients for whom pramlintide, an amylinomimetic, was identified as an appropriate therapeutic option. Practical considerations for clinicians, patient lifestyle factors, and perceptions of pramlintide therapy are also presented.
Footnotes
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Belinda P. Childs, ARNP, MN, BC-ADM, CDE, is a diabetes nurse specialist at MidAmerica Diabetes Associates in Wichita, Kans. Nicole C. Kesty, PhD, is a medical writer at Amylin Pharmaceuticals in San Diego, Calif. Eric Klein, MD, is a practitioner of internal medicine and the director of the Capital Clinical Research Center in Olympia, Wash. Richard Rubin, PhD, CDE, is an associate professor of medicine and pediatrics at The Johns Hopkins University in Baltimore, Md. Allison Wick, MSN, ARNP, CDE, is the director of education and program development at the Diabetes Research Institute, Eleanor and Joseph Kosow Diabetes Treatment Center, at the University of Miami School of Medicine in Florida.
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Note of disclosure: Ms. Childs has served on an advisory panel for and her institution has received research funds from Amylin Pharmaceuticals. Dr. Kesty is an employee of and stock shareholder in Amylin Pharmaceuticals. Dr. Klein is a stock shareholder in and has received honoraria and research support from Amylin Pharmaceuticals. Dr. Rubin has received consulting fees and research support from Amylin Pharmaceuticals. Ms. Wick has served on an advisory board for and is a stock shareholder in Amylin Pharmaceuticals. This company manufactures and markets pramlintide acetate for the treatment of diabetes.
- American Diabetes Association
