Insulin and amylin combination

When pramlintide (brand name Symlin or synthetic amylin) is used in combination with insulin, the benefits for post-prandial glycemic control are substantial.

Pramlintide is a relatively new treatment for diabetes. The treatment involves:
 * a separate injection of pramlintide before a meal,
 * a reduction in insulin bolus by 50% for that meal.

Pramlintide can be infused using an insulin pump. At the present time, the mixing of pramlintide and insulin in the same cartridge is not an approved practice, so two infusion pumps are used simultaneously. Since insulin and amylin are co-secreted by the pancreatic beta cells in response to raising blood glucose levels, using pramlintide and insulin together more closely duplicates the function of the pancreas.

Symlin has potential to support the artificial pancreas project because:
 * Insulin and pramlintide may in the future be automatically infused together
 * at a mixture from a single automatic insulin pump, or
 * two infusion pumps could be used automatically with the insulin pump acting as master and the simlin pump acting as slave, or
 * a dual system in one pump machine (two cartridges, a dual infusion set tube, and two subcutaneous insertions);
 * because it improves post prandial glycemic excursions relative to insulin alone, this supports the possible use of an automatic bolus with less impact due to the delay of the insulin bolus;
 * and because it simply duplicates the natural pancreas function, the full benefits of which are not fully understood.

