Amylin

Abstract

Purpose of review The purpose of this review is to discuss the role of amylin as a glucomodulatory, neuroendocrine hormone, to highlight recent insights into its processing and sensing, to consider the pathogenic relevance of amyloid deposition to diabetogenesis, and to evaluate information relating to the therapeutic use of the amylin analogue, pramlintide. Recent findings Amylin plays a significant role in glucose homeostasis, particularly postprandially, through slowing of gastric emptying and inhibition of glucagon release. Dysregulated processing of the amylin precursor, pro islet amlyoid polypeptide, may result in amyloid deposition, but it remains uncertain whether this represents a primary, or secondary, pathological event in type 2 diabetes. Pramlintide has been evaluated as a therapy in both type 1 and insulin-treated type 2 diabetes, and improves glycaemic control, as assessed by glycated haemoglobin. When administered acutely, pramlintide induces satiety; chronic administration appears to be associated with weight loss. The outcome of studies evaluating the therapeutic use of pramlintide in the management of obesity is awaited. Summary Amylin is an important glucoregulatory, neuroendocrine hormone. Pramlintide represents a novel, and effective, adjunct to therapy in the management of type 1 and insulin-treated type 2 diabetes. While the available information is promising, the efficacy of pramlintide as a weight loss and satiety agent remains to be established.