DM Full Guideline (2010) - VA/DoD Clinical Practice Guidelines Home

Version 4.0
VA/DoD Clinical Practice Guideline
for the Management of Diabetes Mellitus
Amylin analogs
Pramlintide
9%
- Has shown poor compliance
with insulin regimen
- Requires drugs that stimulate
gastrointestinal motility
- Has had recurrent episodes of
severe hypoglycemia requiring
assistance within past 6 months
- Pediatric patients
• Do not mix pramlintide and
insulin in the same syringe; must
be administered as separate
injections
• Administer subcutaneously into
abdominal or thigh areas at sites
distinct from concomitant insulin
injections (do not administer into
arm due to variable absorption)
• Administer concomitant oral
agents, where rapid GI absorption
is a critical determinant of
effectiveness, at least 1 hour prior
to or 2 hours after pramlintide
injection
• When drawing up doses from vial,
inadvertent calculation of dose
based on “units” rather than mL
has resulted in overdose of
pramlintide
• Very expensive
• Nausea
• Hypoglycemia
• Injection site
reactions
Module G: Glycemic Control: Appendices Page 85