Insulin replacement therapy in type 1 diabetes mellitus (T1DM) leads to peripheral hyperinsulinemia, which is associated with potentially serious metabolic complications, such as increased hypoglycemia, weight gain and postprandial hyperglucagonemia. This Review discusses adjunctive therapies to minimize these complications in patients with T1DM, with a focus on the islet amyloid polypeptide analog pramlintide.
