Type 1 Non Insulin Therapies

bottle with syringe

Pramlintide is an injected medicine for people with diabetes.

In type 1 diabetes, Pramlintide can be taken in addition to insulin to help control mealtime blood sugars.

Pramlintide (Symlin)

Pramlintide is an injected medicine for people with type 1 and type 2 diabetes that helps control blood sugar levels after eating. Pramlintide resembles the hormone, amylin that is normally released along with insulin from the pancreatic beta cells. In type 1 diabetes, amylin levels are absent because the pancreatic beta cells have been destroyed.

Pramlintide lowers glucagon during a meal, slows food emptying from the stomach and curbs the appetite.

Side Effects

Some people get certain side effects (such as nausea, vomiting and low blood sugar) when starting pramlintide, therefore the starting dose is small to allow the body to adjust to this new medicine.


When you have type 1 diabetes, the initial dose of pramlintide is 15 micrograms (2.5 units on the insulin syringe), taken before meals. After 3 days, if you tolerate the medicine, the dose may be increased to 30 micrograms (5 units on the insulin syringe) before meals. The dose can be increased every three days as tolerated to a maximum dose of 60 micrograms before each meal. The meal must contain at least 30 grams of carbohydrate. Pramlintide is available in a vial and pen form.

When you are starting pramlintide:

  • Reduce your mealtime insulin dose by half or more to prevent a low blood sugar. Ask your medical provider for exact recommendation.
  • If using an insulin pump, extending the meal bolus to 1 ½ or 2 hours may prevent early post meal hypoglycemia and late post meal hyperglycemia related to the delayed stomach emptying.
  • Inject pramlintide at the same time you inject insulin, but at a different injection site.
  • Do not mix pramlintide with insulin in the same syringe.

The most common side effects are:

  • Nausea
  • Vomiting
  • Headache
  • Low blood sugar

If you have side effects, contact your medical provider immediately.


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