Pramlintide, a synthetic amylin analog, improves glycemic control in diabetes by delaying gastric emptying, suppressing glucagon secretion, and suppressing appetite.  Marketed as Symlin, it's administered subcutaneously (onset ~20 minutes, half-life ~48 minutes) and is FDA-approved as an insulin adjunct for both type 1 and type 2 diabetes to improve postprandial glucose control.  It's not mixed with insulin.  Investigational uses include weight management (with metreleptin), neurodegenerative disorders (amyloid-related pathologies), non-diabetic hyperglycemia, and as an adjunct with GLP-1 agonists in type 2 diabetes. Common side effects are nausea, vomiting, hypoglycemia, and headache; contraindications include severe hypoglycemia history and gastroparesis.  Careful titration and frequent blood glucose monitoring are crucial to avoid hypoglycemia.