Generality
Amylin is a peptide hormone synthesized by pancreatic β cells together with insulin, and co-secreted in response to meals and hyperglycemic conditions.
Like insulin, amylin is particularly active in glucose metabolism, so much so that its synthetic analogue ( pramlintide ) has been authorized by the FDA as a medicine to treat diabetes mellitus (trade name Symlin ®), both type I and type II, in synergy with insulin.
Just like the drugs containing insulin, the pramlintide must be administered by subcutaneous injection, since once ingested it would be completely inactivated, as is the case for food-borne proteins.
Therapeutic Effects
Amiline and pramlintide proved to be capable of:
- slow gastric emptying
- decrease digestive secretions (bile, gastric, enteric and pancreatic juices)
- reduce plasma glucagon, a catabolic hormone with hyperglycaemic effects
- increase the sense of satiety
- reduce post-prandial glycaemia overall, 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 appearance of nausea and vomiting. The potential ability to promote body weight, given the anorectic effects expressed at central level, make the amylin derivatives of particular utility in obese diabetics.
Excess of Amiline 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 is found 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.
