Pramlintide, used as an adjunct to mealtime insulin in diabetes, achieves its glycaemic effect through which combination of actions?

• A Blocking intestinal alpha-glucosidase and delaying starch digestion
• B Closing beta-cell KATP channels and enhancing first-phase insulin release
• C Slowing gastric emptying, suppressing postprandial glucagon secretion and promoting satiety ✓
• D Agonism at PPAR-gamma and redistribution of visceral fat

Explanation

Pramlintide is a synthetic analogue of amylin, the peptide co-secreted with insulin from beta cells. It slows gastric emptying, suppresses inappropriate postprandial glucagon release and acts centrally to increase satiety, thereby blunting the postprandial glucose rise. Option B is the sulfonylurea mechanism, option A is acarbose, and option D is pioglitazone. Its main limiting toxicity is nausea and delayed gastric emptying in gastroparesis.

Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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