{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:49:31Z","timestamp":1790261371126,"version":"4.1.0"},"reference-count":26,"publisher":"American Diabetes Association","issue":"1","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2003,1,1]]},"abstract":"<jats:p>OBJECTIVE\u2014To assess the effects of adjunctive treatment with pramlintide, an analog of the \u03b2-cell hormone amylin, on 24-h glucose fluctuations and postprandial glucose, glucagon, and triglyceride excursions in patients with type 1 diabetes intensively treated with continuous subcutaneous insulin infusion (CSII).<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014In this study, 18 patients (16 of whom could be evaluated) with type 1 diabetes (age 44 \u00b1 11 years, HbA1c 8.2 \u00b1 1.3% [mean \u00b1 SD]) were given mealtime injections of 30 \u03bcg pramlintide t.i.d. for 4 weeks in addition to their preexisting CSII regimen (16 lispro, 2 regular insulin). Mealtime insulin boluses were reduced by a minimum of 10% during the first 3 days, and re-adjusted thereafter based on clinical judgment. At weeks 0 (baseline), 4 (on treatment), and 6 (2 weeks off treatment), 24-h interstitial glucose concentrations were measured using a continuous glucose monitoring system (CGMS), and postprandial plasma glucose, glucagon, and triglyceride concentrations were measured in response to a standardized test meal.<\/jats:p>\n               <jats:p>RESULTS\u2014At baseline, patients had excessive 24-h glucose fluctuations, with 59% of the CGMS measurements &amp;gt;140 mg\/dl, 13% &amp;lt;80 mg\/dl, and only 28% in the euglycemic range (80\u2013140 mg\/dl). After 4 weeks on pramlintide, measurements in the hyperglycemic range declined to 48% and measurements within the euglycemic range increased to 37%. This shift from the hyperglycemic to the euglycemic range occurred with a concomitant 17% reduction in mealtime insulin dosages and without relevant increases in measurements below the euglycemic range (15%) or any severe hypoglycemic events. After 4 weeks on pramlintide, postprandial glucose, glucagon, and triglyceride excursions were reduced by \u223c86, \u223c87, and \u223c72%, respectively (incremental areas under the curve, all P &amp;lt; 0.05 vs. baseline). At week 6 (off treatment), the 24-h glucose profile and postprandial glucose, glucagon, and triglyceride excursions approached pretreatment values.<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014In this study, the addition of pramlintide to insulin therapy reduced excessive 24-h glucose fluctuations as well as postprandial glucose, glucagon, and triglyceride excursions in patients with type 1 diabetes intensively treated with insulin pumps.<\/jats:p>","DOI":"10.2337\/diacare.26.1.1","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T22:51:27Z","timestamp":1173135087000},"page":"1-8","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":116,"title":["Impact of Pramlintide on Glucose Fluctuations and Postprandial Glucose, Glucagon, and Triglyceride Excursions Among Patients With Type 1 Diabetes Intensively Treated With Insulin Pumps"],"prefix":"10.2337","volume":"26","author":[{"given":"Claresa","family":"Levetan","sequence":"first","affiliation":[{"name":"Medstar Clinical Research Center, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura L.","family":"Want","sequence":"additional","affiliation":[{"name":"Medstar Clinical Research Center, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Weyer","sequence":"additional","affiliation":[{"name":"Amylin Pharmaceuticals, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan A.","family":"Strobel","sequence":"additional","affiliation":[{"name":"Amylin Pharmaceuticals, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Crean","sequence":"additional","affiliation":[{"name":"Amylin Pharmaceuticals, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[{"name":"Amylin Pharmaceuticals, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Maggs","sequence":"additional","affiliation":[{"name":"Amylin Pharmaceuticals, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orville G.","family":"Kolterman","sequence":"additional","affiliation":[{"name":"Amylin Pharmaceuticals, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manju","family":"Chandran","sequence":"additional","affiliation":[{"name":"Veterans Affairs, San Diego Healthcare System, University of California San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunder R.","family":"Mudaliar","sequence":"additional","affiliation":[{"name":"Veterans Affairs, San Diego Healthcare System, University of California San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R.","family":"Henry","sequence":"additional","affiliation":[{"name":"Veterans Affairs, San Diego Healthcare System, University of California San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031215090971700_R1","doi-asserted-by":"crossref","unstructured":"Klein R, Klein BE, Moss SE, Cruickshanks KJ: The medical management of hyperglycemia over a 10-year period in people with diabetes. 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