Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this newsletter: Dalia Elabed, PharmD Candidate 2022, University of South Florida Taneja College of Pharmacy Destiny Funchess, PharmD Candidate, Tougaloo College, South College School of Pharmacy Kornelia Ilias, Creighton University | School of Pharmacy and Health Professions Doctor of Pharmacy Candidate Class of 2022 Ding Nguyen, PharmD Candidate, University of South Florida Taneja College of Pharmacy | 
It has been almost 15 years since Symlin (pramlintide) was first approved as an amylin replacement. Amylin is a hormone that is produced in the beta cells of the pancreas and works to prolong gastric emptying time, reduce postprandial glucagon secretion, and reduce caloric intake. When a patient develops type 1 diabetes, they lose the ability to produce insulin as well as amylin. This makes glucose control much harder. I remember when Amylin brought Symlin to market, and how many of us viewed this as a great product for type 1 patients. There were two things that affected the use of Symlin. You could not mix it with insulin, so that meant 2-3 extra shots a day; and Amylin brought Byetta to England that same year, and attention turned to the once a day shot.