Amylin and JDRF Collaborate to Explore Combining Insulin and Symlin in One Injection
Amylin and JDRF will be looking into the possibility of combining Symlin and insulin into one injection.
Earlier this month, Amylin and JDRF entered a partnership to investigate the feasibility of combining Symlin (pramlintide) with insulin in a fixed ratio into one injection and to see how effective it is as a treatment for type 1 diabetes compared to insulin therapy alone. As background, Symlin is an analog of the human hormone amylin, a compound normally produced by healthy pancreases (see Test Drive in diaTribe #2). Amylin and insulin work in tandem to regulate blood glucose levels. Specifically, amylin helps to control the rate at which glucose enters the blood stream immediately following meals, blunts the secretion of glucose by the pancreas, and enhances feelings of fullness. Since individuals with type 1 diabetes do not produce either insulin or amylin, the ideal management of blood sugar levels would involve replacement of both hormones.
However, Symlin’s dosing and side effects have often precluded its use – only a small percentage of people with type 1 diabetes currently use the therapy. As such, Amylin and JDRF are developing studies to assess how well insulin and Symlin work together in a single injection. Bringing these two hormones together would likely more closely represent the natural workings of the pancreas due to the fact that insulin and amylin are used simultaneously in the body to stabilize blood glucose levels; thus, individuals would likely be able to remain in the normal glucose range longer. Also, co-formulation would reduce the complexity of daily treatment by eliminating one injection from an individual’s routine. However, there is one potential drawback – insulin and Symlin cannot be titrated individually in the co-formulation. Thus, for the select few who are willing to forego the convenience of fewer injections, taking insulin and Symlin in separate injections may ultimately still allow for the best control. For practical tips on how to use Symlin, please see our Thinking Like A Pancreas column in diaTribe #20. --KRC/VW
