Considering pramlintide therapy for postprandial blood glucose control

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.