amylin

Amylin is insulin's quieter partner. Every time a beta cell releases insulin, it co-releases amylin from the same granules, and amylin works on the side that insulin neglects: it slows how fast food leaves the stomach, blunts the post-meal glucagon spike, and promotes a feeling of fullness. Together these effects smooth out the rise in blood sugar after eating.

Amylin acts largely through the brain, signaling in the hindbrain to increase satiety and reduce food intake. By delaying gastric emptying, it spaces out the arrival of glucose into the blood so insulin is not overwhelmed all at once. It thus complements insulin by reducing both the height and the speed of glucose surges.

Amylin has a notable downside: in humans it readily misfolds and aggregates into amyloid deposits within islets, and these deposits are a hallmark of type 2 diabetes that may contribute to beta-cell loss. A stabilized synthetic analog, pramlintide, is used as an add-on to insulin to improve post-meal control.