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Pramlintide Effective Adjunctive Therapy for Diabetes

Modest improvements seen in HbA1c and weight in some with types 1 and 2 diabetes

THURSDAY, Nov. 11 (HealthDay News) -- The synthetic amylin analogue pramlintide appears to be somewhat more effective than placebo as adjunctive treatment for diabetes in several clinical scenarios, according to research published in the November/December issue of the Annals of Family Medicine.

Nancy J. Lee, of the Oregon Health & Science University in Portland, and colleagues conducted a systematic review of randomized controlled trials studying the efficacy, effectiveness, and harms of pramlintide as adjunct therapy in adults and children with type 1 or type 2 diabetes. Seven trials met the inclusion criteria. Due to heterogeneity of data, a meta-analysis could not be performed and only qualitative data were synthesized.

The researchers found that pramlintide was more effective than placebo for type 1 diabetes in patients using conventional (but not intensive) insulin therapy, with a difference in HbA1c levels of 0.2 to 0.3 percent in two studies. In patients with type 2 diabetes on flexibly-dosed glargine (without prandial insulin) or fixed-dose insulin therapies, with or without oral hypoglycemic agents, pramlintide was also more effective than placebo at reducing HbA1c, with a difference of approximately 0.4 percent. Patients with type 1 and type 2 diabetes lost weight on pramlintide, while those on placebo showed a tendency toward weight gain, but patients on pramlintide also had more frequent nausea and severe hypoglycemia.

"Pramlintide may have a role in glycemic control in some patients with type 1 or type 2 diabetes. Although improvements in HbA1c levels are small, incremental improvements in HbA1c levels of 0.2 to 0.4 percent from the addition of pramlintide may ultimately contribute to long-term glycemic control and cardiovascular health when combined with other means of improving glycemic control," the authors write.

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