For the most part, anyone who suffers from diabetes or lives with someone with diabetes has at least some basic knowledge about what insulin is and why it is important. People may even have a decent understanding about the mechanism between insulin and glucagon and how these two pair together to help maintain glucose levels. The feedback loop between insulin and glucagon was used to explain how sugars are regulated with or without food ingestion, however there is yet another factor that helps maintain balance between insulin spikes, sugar equilibrium and insulin/glucagon dispersion, and this is called Amylin.
Amylin is a small peptide hormone that is released by the same beta cells as insulin. The function of amylin is still not completely understood since it was discovered recently over the last 20-25 years; however, scientist are starting to find the relevance this peptide hormone plays on the body and how important it is for glucose control. Let’s take a look at these recent discoveries and see what the big hype of amylin is all about.
Not only are insulin and amylin secreted by the same type of cells (beta cells) they are also secreted at the same time. Studies show that the insulin/amylin ratio is around 100-1. Since both of these hormones are secreted at the same time, how do we differentiate them from a physiological perspective?? The main function of amylin is to prevent sugar spikes from occurring right after a meal. Generally speaking, insulin controls how much sugar is moved from your blood to your muscles and tissues in the body, whereas Amylin controls how much sugar gets into your bloodstream and how fast it gets there. The way amylin does this is by:
- Decreasing appetite (since amylin works with the brain during digestion)
- Slows gastric emptying/inhibits secretion of digestive enzymes ( this will also slow down the presence of glucose in the blood)
- Inhibits glucagon production (this will also lower the amount of glucose present in the blood)
One of the biggest concerns for people with diabetes is that even if the proper amount of insulin is taken, (or the oral medications are used correctly) there are still moments where blood sugar spikes occur which is what makes tight blood glucose control so hard to achieve. Studies have shown that people with type 1 diabetes or insulin dependent type 2 diabetes have an amylin deficiency or produce none at all. This makes sense especially for people with type 1 diabetes since beta cells are destroyed due to an autoimmune response. So when there are no beta cells there is no insulin or amylin.
Scientists are getting closer and closer to understanding the mechanisms behind glucose metabolism and diabetes. With new information, some scientists even believe that diabetes in general (both type 1 and type 2) has to do with amylin production and not insulin!! Since blood sugar spikes are very common for people with type 1 and insulin dependent type 2 diabetes, it may be beneficial to talk with your doctor about the best times to inject insulin so that you can minimize the peaks from your meal and help you digest your food in a more natural manner.