PMID- 35137513
OWN - NLM
STAT- MEDLINE
DCOM- 20220421
LR  - 20230602
IS  - 1463-1326 (Electronic)
IS  - 1462-8902 (Print)
IS  - 1462-8902 (Linking)
VI  - 24
IP  - 6
DP  - 2022 Jun
TI  - Pramlintide for post-bariatric hypoglycaemia.
PG  - 1021-1028
LID - 10.1111/dom.14665 [doi]
AB  - AIMS: The aim of this study was to examine the hypothesis that pramlintide would 
      reduce hypoglycaemia by slowing gastric emptying and reducing postprandial 
      glucagon secretion, thus limiting postprandial glycaemic excursions and insulin 
      secretion, and thus to determine the efficacy of pramlintide on frequency and 
      severity of hypoglycaemia in post-bariatric hypoglycaemia (PBH). MATERIALS AND 
      METHODS: Participants with PBH following gastric bypass were recruited from 
      outpatient clinics at the Joslin Diabetes Center, Boston, Massachusetts for an 
      open-label study of pramlintide efficacy over 8 weeks. Twenty-three participants 
      were assessed for eligibility, 20 participants had at least one pramlintide dose, 
      and 14 completed the study. A mixed-meal tolerance test (MMTT) was performed at 
      baseline and after 8 weeks of subcutaneous pramlintide with a sequential dose 
      increase to a maximum of 120 micrograms (mean 69 +/- 32 mcg) three times daily. The 
      primary endpoint was change in glucose excursions during the MMTT. Secondary 
      measures included MMTT insulin response, satiety and dumping score, percentage 
      time with sensor glucose (SG) <3.9 mM, and number of days with minimum SG <3 mM, 
      during masked continuous glucose monitoring. RESULTS: There were no differences 
      in MMTT glucose, glucagon or insulin between baseline and post treatment. We 
      observed no significant change in satiety or dumping scores. The overall 
      frequency of low SG values did not change, although there was substantial 
      inter-individual variability. CONCLUSIONS: In PBH, pramlintide does not modulate 
      glycaemic or insulin responses, satiety, or dumping scores during an MMTT and 
      does not impact glycaemic excursions or decrease low SG levels in the outpatient 
      setting.
CI  - (c) 2022 John Wiley & Sons Ltd.
FAU - Sheehan, Amanda
AU  - Sheehan A
AD  - Research Division, Joslin Diabetes Center, Boston, Massachusetts, USA.
FAU - Goldfine, Allison
AU  - Goldfine A
AD  - Research Division, Joslin Diabetes Center, Boston, Massachusetts, USA.
AD  - Harvard Medical School, Boston, Massachusetts, USA.
FAU - Bajwa, Muhammed
AU  - Bajwa M
AD  - Research Division, Joslin Diabetes Center, Boston, Massachusetts, USA.
FAU - Wolfs, Danielle
AU  - Wolfs D
AD  - Research Division, Joslin Diabetes Center, Boston, Massachusetts, USA.
FAU - Kozuka, Chisayo
AU  - Kozuka C
AD  - Research Division, Joslin Diabetes Center, Boston, Massachusetts, USA.
AD  - Harvard Medical School, Boston, Massachusetts, USA.
FAU - Piper, Jacqueline
AU  - Piper J
AD  - Research Division, Joslin Diabetes Center, Boston, Massachusetts, USA.
FAU - Fowler, Kristen
AU  - Fowler K
AD  - Research Division, Joslin Diabetes Center, Boston, Massachusetts, USA.
FAU - Patti, Mary Elizabeth
AU  - Patti ME
AUID- ORCID: 0000-0002-8163-3429
AD  - Research Division, Joslin Diabetes Center, Boston, Massachusetts, USA.
AD  - Harvard Medical School, Boston, Massachusetts, USA.
LA  - eng
GR  - P30 DK036836/DK/NIDDK NIH HHS/United States
GR  - R01 DK121995/DK/NIDDK NIH HHS/United States
PT  - Journal Article
DEP - 20220309
PL  - England
TA  - Diabetes Obes Metab
JT  - Diabetes, obesity & metabolism
JID - 100883645
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Insulin, Regular, Human)
RN  - 0 (Islet Amyloid Polypeptide)
RN  - 9007-92-5 (Glucagon)
RN  - D3FM8FA78T (pramlintide)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - *Bariatric Surgery/adverse effects
MH  - Blood Glucose
MH  - Blood Glucose Self-Monitoring
MH  - Glucagon/therapeutic use
MH  - Glucose/therapeutic use
MH  - Humans
MH  - *Hypoglycemia/etiology/prevention & control
MH  - Hypoglycemic Agents/therapeutic use
MH  - Insulin/therapeutic use
MH  - Insulin, Regular, Human/therapeutic use
MH  - *Islet Amyloid Polypeptide/therapeutic use
PMC - PMC9035096
MID - NIHMS1778520
OTO - NOTNLM
OT  - bariatric surgery
OT  - continuous glucose monitoring (CGM)
OT  - glucagon
OT  - hypoglycaemia
EDAT- 2022/02/10 06:00
MHDA- 2022/04/22 06:00
PMCR- 2023/06/01
CRDT- 2022/02/09 06:04
PHST- 2022/01/27 00:00 [revised]
PHST- 2021/10/28 00:00 [received]
PHST- 2022/02/06 00:00 [accepted]
PHST- 2022/02/10 06:00 [pubmed]
PHST- 2022/04/22 06:00 [medline]
PHST- 2022/02/09 06:04 [entrez]
PHST- 2023/06/01 00:00 [pmc-release]
AID - 10.1111/dom.14665 [doi]
PST - ppublish
SO  - Diabetes Obes Metab. 2022 Jun;24(6):1021-1028. doi: 10.1111/dom.14665. Epub 2022 
      Mar 9.