Symlin Curbs Oxidative Stress in Diabetics

As well as reducing postprandial glucose excursion in type 1 diabetics, the drug pramlintide reduces markers of oxidative stress — the imbalance between free radical production and clearance by antioxidants. Dr. David G. Maggs, chief investigator, stated that, "With acute dosing of the amylin hormone analog, pramlintide, at mealtime you see a prevention in the abnormal rise in plasma glucose so often see in patients with diabetes. This is coupled with a prevention in the abnormal rise in oxidative stress markers that may play a role in causing the vascular problems these patients face."

Dr. Maggs of Amylin Pharmaceuticals, San Diego, and colleagues came to this conclusion after a single-blind crossover study of 18 type 1 diabetics.

They underwent two standardized breakfast meal tests and received pramlintide or placebo in addition to their preprandial insulin.

During the 4-hour postprandial period, compared to placebo, pramlintide significantly reduced postprandial excursions of glucose, nitrotyrosine and oxidized LDL and prevented a decline in total radical-trapping antioxidant parameters.

The researchers thus conclude that as well as having a postprandial glucose-lowering effect, use of the agent "is associated with a significant reduction in postprandial oxidative stress."

"It is difficult to extrapolate too much from the results of a study involving just acute dosing," added Dr. Maggs, "but the findings are interesting nevertheless."

Earlier in 2004, Amylin withdrew its marketing application for Symlin from Swiss regulators, after authorities there said the drug could not be approved because of concerns whether the benefits of Symlin outweighed risks such as nausea and hypoglycemia.
Diabetes Care 2005;28:632-637.