Type 1 Diabetes
An autoimmune disease where the immune system destroys insulin-producing beta cells, requiring lifelong insulin therapy. Type 1 diabetes is distinct from type 2. Pramlintide (an amylin analogue) is the only approved peptide drug specifically indicated as an adjunct to insulin in type 1 diabetes.
Technical Context
T1D is an autoimmune disease where CD4+ and CD8+ T cells destroy pancreatic beta cells, leading to absolute insulin deficiency. Onset typically occurs in childhood/adolescence but can occur at any age. Management requires exogenous insulin replacement (basal-bolus regimen or insulin pump). Pramlintide (synthetic amylin analogue) is the only non-insulin peptide drug specifically indicated for T1D — it addresses the amylin deficiency that accompanies insulin deficiency (amylin is co-secreted with insulin from beta cells). Pramlintide reduces postprandial glucagon secretion, slows gastric emptying, and promotes satiety, improving postprandial glucose control when added to insulin. GLP-1 RAs are NOT approved for T1D (inadequate beta cell mass to respond to GLP-1R stimulation), though investigational studies have explored adjunctive use.