Diabetes Self-Management Blog

Two studies published this summer have found that the injected diabetes drug pramlintide (brand name Symlin) may help obese people lose weight.

Pramlintide is a synthetic analog of the hormone amylin, which is usually secreted by the pancreas along with insulin in response to meals. In the body, amylin works with insulin to control the rise in blood glucose levels after eating. People with diabetes whose pancreases don’t produce enough insulin (or any insulin) also don’t produce enough amylin at mealtimes.

Pramlintide was approved by the U.S. Food and Drug Administration (FDA) in March 2005 for use in people with Type 1 diabetes and people with Type 2 diabetes who use insulin. Pramlintide helps control blood glucose levels by several mechanisms, including slowing stomach emptying. This action can also help people feel more full and eat less food.

Previously published studies have shown that using pramlintide can help people with Type 2 diabetes, who are often overweight, lower both their HbA1c levels and their weight. Now, two new studies have looked specifically at pramlintide’s role in helping obese people lose weight.

In one study, published in the August issue of The Journal of Clinical Endocrinology and Metabolism, researchers recruited 204 people with an average body-mass index (BMI) of 37.8 (a BMI over 30 is classified as obese). These people were randomly assigned to take injections of either pramlintide or a placebo three times a day before meals for four months. Both groups also received lifestyle interventions aimed at weight loss.

Compared with the placebo group, the participants who received pramlintide lost about eight pounds and almost 1 1/2 inches from their waistlines. Also, a greater percentage of the pramlintide group (31%) lost 5% or more of their body weight compared to 2% of the placebo group, and a substantially higher percentage of people in the pramlintide group reported better appetite control and improved well-being. Nausea was the most common side effect associated with pramlintide, and both groups had a similar percentage of withdrawal from the study: 29% of the pramlintide group and 25% of the placebo group.

Another study, published in the American Journal of Physiology - Endocrinology and Metabolism in August looked at 88 obese people randomly assigned to inject either pramlintide or a placebo before each meal for six weeks. Over this period, the people who received pramlintide ate between 500 and 750 fewer calories per day than the people who received the placebo. They also ate smaller portions and were less likely to binge eat when presented with food such as pizza, soda, and ice cream during “fast food challenges.” At the end of the study period, members of the pramlintide group had lost an average 2% of their body weight while members of the placebo group had gained a small amount of weight.

Both studies received funding from Amylin Pharmaceuticals, Inc., which manufactures pramlintide.

FDA approval for pramlintide purely as a weight-loss drug is probably still years in the future; meanwhile, other studies are under way to test the weight-loss effects of combining pramlintide with other drugs and synthetic hormones. For people with diabetes who are overweight and use insulin, however, pramlintide may be able to help them lose weight in addition to helping control postmeal blood glucose levels.

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Comments
  1. If this is true it is wonderful. The main problem with tight control using insulin is the associated weight gain that undoes the good resulting from near normal blood sugar. I wonder if it is available in Canada.

    Posted by Calgary Diabetic |
  2. I have used symlin for 6 mos and have lost 32 lbs. alone with eating in a behavoir way. 1200 to 1500 calories a day plus excising at curves.
    previous i had not lost any weight in 10 years with just insulin. judy h.

    Posted by Judy H. |
  3. I was on Symlin for just over a month but I could’nt stand the nausea and vomiting that I had while I was taking it. While I was on it I did lose 8 lbs but after I injected it I got so sick I couldn’t eat. I know this side effect is suppose to go away but after a month I couldn’t take it anymore.

    Anne

    Posted by amw2769 |
  4. Has anyone been prescribed Symlin, that is not taking ANY form of insulin. My doctor has put me on Symlin due to weight and a 6.6 glyco. The only other medication I take is synthroid. I am just curious because I can find no mention of anyone taking Symlin alone.

    Posted by Vanessa |
  5. i am not diabetic, but my husband is diabetes and i think is useful if i can received information on behalf.

    Posted by mbwille |
  6. I am taking symlin by itself. I have been on it for about 1 month and i have lost about 5 pounds. I don’t have any nausea. I do feel fuller sometimes, but I thought it was going to work a little quicker than it has been. But I can’t take any diet pills so my doctor offered this to try.

    Posted by Kelli |
  7. I am sad to say that I have not lost any weight when Symlin added to my Apidra insulin (pump). However, my A1c has been wonderful - 6.1. My problem is that I don’t know how much longer I can afford it. It is sad because I do feel so much better - I have type 1 diabetes and take around 40 Apidra and 120 Symlin. For all the years I have taken it it was considered to be a form of insulin and paid for by my insurance, just as my Apidra is. This year my former employer changed to a different insurance and now they have ruled that Symlin is not a form of insulin, but rather a medication and therefore on the mailorder (3 months supply) is $218. I am living on a fixed income and can barely afford all the drugs (thank goodness for charge cards - though eventually they have to be paid!) I talked to the insurance co. pharmacist and asked why suddenly I now have to pay for the Symlin insulin and they told me that I could not expect them to pay $2,000 for a 3 month supply!!! I have told my Endocrinologist that I will have to stop taking it - but he says he will help me fight it. How in the world can I fight a drug ruling by an insurance company? I think Symlin is wonderful and extremely helpful. I have other health issues that contribute to my obesity as well - I’m just so tired of fighting with insurance companies. Any ideas for me?

    Posted by Sue |
  8. I have used Byette in the past, which is like Symlin but not used with insulin therapy. I lost 25lbs while using it,but had to go off of it d/t episodes of hypoglycemia, my Dr replaced it with low doses of Novolog @ each meal. I gained all the weight back, plus more.My Dr has now put me on Symlin, in hope that I will be better controled @ once again lose the weight, I am really hoping this works! In reply to Sue on Aug 14,2011,Ther should be a 1-800 phone number or web site that you can contact for help with the cost, alot of manufactures are now offering low to free cost for people on fixed incomes that need this medication, I really hope this helps you & some of the other people that are unsure about Symylin.

    Posted by Vicki Hawk |
  9. I live in Canada, I have never heard of sylimin at all, and I would sure like to lose weight,I ow take two different isluin,but I dont lose weight.
    Is in Canada at all,if you know please would you ansewer. thank you Doreen

    Posted by Doreen Glasspoole |
  10. i have never hear of sylimin before.I have been trying to loss weight for the last 14 years without enough sucess. is this sylimin really good and what are the side effects.how much will it cost me monthly,and can i request it from my doctor.

    Posted by Sheronda P |
  11. Hey all,
    I’m a 31 yr old, 5′7″ female. I am not a diabetic! I am right now 189 lbs. I’ve had a complete hysterectomy as well. I’m trying so hard to lose weight. My dr put me on metformin for about 6 months but I didn’t lose any weight. I’ve tried over the counter diet pills for 4 months and the HCG B12 B6 shot for 6 months. I only gained weight. I wasn’t on these together though. Now my dr has prescribed me the Symalin and Topomax together. I just got it today and my hubby and I read up on the symalin and we are nervous for me to take it. I am desperate to lose at least the 40 pounds I’m overweight for my age and height. I’m scared that if I use the symalin I will become a diabetic. Should I begin the 120 Mcg doses? Has anyone NOT a diabetic taken Symalin and lost weight without becoming very nauseas or becoming a Diabetic? Please help! I’m supposed to start in the morning!
    Thanks

    Posted by Tiffany |
  12. There is a drug in Canada and I in here to try to find the name. I think it starts with the letter V.
    My Dr. told me it is very expensive and if you don’t have a drug plan, you pay.
    It is not covered for seniors in Canada.

    Posted by Louise |
  13. Hi Louise,

    Thanks for your comment. The drug you’re thinking of may be Victoza. For more information, check out Jan Chait’s blog entry, “Victoza Approved for Use. Should You Take It?”

    Thank you for your interest in Diabetes Self-Management!

    Best,
    Diane Fennell
    Web Editor

    Posted by Diane Fennell |
  14. Hi I’m a type 1 diabetic, after 18 years Dr’s took me off insulin
    And I lost 27 plus kgs.. After not feeling well for a few weeks
    A trip back to Dr’s went back on my insulin after being off it
    For 7 months and the amazing hard work at losing weight..
    Now that I’m back on insulin, I have gained 1.8kgs in 9 days ..
    NOT HAPPY .. Is this drug available in Australia ..

    Thank you

    Posted by Sharon |
  15. Hi, I just started using Symlin and I been feeling full and not hungry at all, I hope i loss all the weight that I had gain over the years. My A1c has been ok 6.6 I hope it works for me.

    Posted by Elizabeth |

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