Amylin infusion improves time in range and variability over insulin only artificial pancreas system.
When we discuss the future of insulin delivery technology the topic of dual hormone therapy typically comes up. Typically we are thinking of those hormones as insulin and glucagon, with insulin lowering blood sugars while glucagon prevents hypoglycemia.
However, in a recent study presented at The American Diabetes Association’s 78th Scientific Sessions, results of a dual hormone artificial pancreas system were presented. In this case the hormones used were Insulin and Amylin.
What is Amylin?
Amylin is a hormone secreted with insulin by pancreatic beta cells. This hormone reduces glucagon secretion, slows gastric emptying and increases satiety. But, due to the beta cell damage that leads to type 1 diabetes, people with type 1 diabetes also lose our ability to produce amylin.
In a three session controlled test patients found a 12% increase in time in target range during daytime hours using a fixed ratio of amylin to rapid acting insulin in comparison to rapid insulin only. (Both of which out performed regular insulin/amylin delivery).
Overnight use shows that rapid acting insulin only systems showed 6%higher more time in range with rapid acting/amylin just behind. (again regular/amylin delivery falling well short) it was also found that participants using the rapid/amylin delivery showed reduced glycemic variability over the study period.
One of the largest limiting factors in current amylin supplementation therapies is nausea sometimes associated with medications. In this study 1/6 participants reported nausea.
This study demonstrates that the co infusion of rapid acting insulin with amylin demonstrates improved time in range and reduced variation. perhaps rather than dual hormone therapy, we should be anticipating tri-hormone therapy from our future artificial pancreas systems.
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