A type 1 diabetes patient on basal-bolus insulin has persistently elevated fasting glucose (180 mg/dL) despite adequate basal insulin. The physician adds pramlintide before meals. Which mechanism explains pramlintide's glucose-lowering effect?

• A Suppresses hepatic gluconeogenesis by activating AMPK
• B Delays gastric emptying and suppresses postprandial glucagon secretion ✓
• C Increases insulin secretion by closing K-ATP channels
• D Increases peripheral glucose uptake via GLUT4 translocation

Explanation

Pramlintide is a synthetic amylin analog. It lowers postprandial glucose by delaying gastric emptying, suppressing postprandial glucagon secretion, and promoting satiety via central mechanisms. It is used as an adjunct in type 1 and type 2 diabetes. It does not stimulate insulin secretion, and its weight loss benefit is modest compared to GLP-1 agonists.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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