What hormone is co-secreted with insulin from pancreatic beta cells and acts to regulate blood glucose by delaying gastric emptying and suppressing post-meal glucagon secretion?

Amylin

The hormone co-secreted with insulin from pancreatic beta cells that regulates blood glucose by delaying gastric emptying and suppressing post-meal glucagon secretion is amylin. 1

Physiological Role and Mechanism

Amylin is colocated with insulin in secretory granules and cosecreted with insulin by pancreatic beta cells in response to food intake, showing similar fasting and postprandial patterns in healthy individuals. 1

Key Mechanisms of Action

Amylin regulates postprandial glucose through multiple complementary pathways:

• Slows gastric emptying (the rate at which food is released from the stomach to the small intestine) without altering overall nutrient absorption 1
• Suppresses postprandial glucagon secretion (not normalized by insulin alone), leading to suppression of endogenous hepatic glucose output 1
• Regulates food intake through centrally-mediated modulation of appetite 1

Clinical Significance in Diabetes

Amylin Deficiency States

In patients with type 1 and type 2 diabetes, there is reduced secretion from pancreatic beta cells of both insulin and amylin in response to food. 1

• Type 1 diabetes patients have a dual defect: amylin levels are markedly lower than in the general population and do not respond to meal stimuli, dramatically impairing homeostatic controls on food intake 2
• Type 2 diabetes patients show dampened postprandial amylin release in the context of obesity and insulin resistance 2
• Amylin deficiency contributes to inability to control postprandial glucose levels and has anorexigenic effects 2

Therapeutic Implications

Amylin replacement with pramlintide (an amylin analog) demonstrates that these functions are not replaced with insulin monotherapy alone. 2

• Pramlintide adjunctive use with prandial insulin in type 1 diabetes patients is associated with improvements in postprandial and overall glucose control, as well as weight loss 2
• The amylin analog acts through mechanisms similar to native amylin: slowing gastric emptying, reducing postprandial plasma glucagon rise, and modulating satiety leading to decreased caloric intake 1

Comparison with GLP-1

While both amylin and GLP-1 delay gastric emptying, they differ fundamentally in their origin and secretion patterns:

• Amylin originates from pancreatic beta cells and is cosecreted with insulin 1
• GLP-1 is an incretin hormone from the gastrointestinal tract that regulates body weight by diminishing appetite and delaying gastric emptying upon central nervous system activation 2
• GLP-1 levels in type 1 diabetes are similar to healthy controls with no difference in postmeal rise, whereas amylin is markedly deficient 2