"Anything Meds Can Do, You Can Do Better" Part 9 of 12 - Islet Amyloid Polypeptide (IAPP) Toxicity

Islet Amyloid Polypeptide (IAPP) Toxicity: When Amylin Turns Toxic and Hurts Beta Cells

This episode breaks down Islet Amyloid Polypeptide (IAPP) Toxicity in plain language. We explain what amylin does, how it misfolds into toxic amyloid, why that harms insulin-making beta cells, which meds may help, and the daily habits that lower risk. We keep it real, practical, and hopeful.

 

Timestamps

• 00:00 — Welcome and why IAPP toxicity matters
• 01:00 — What amylin (IAPP) does in a healthy body
• 02:00 — GLP-1s vs. normal hormones (clearing up the mix-up)
• 04:00 — When amylin gets overproduced and misfolds
• 05:00 — Toxic amyloid hurts beta cells and sparks inflammation
• 06:00 — DeFronzo’s baboon study and the “bad soil” islet analogy
• 08:00 — IAPP plaques and how this mirrors amyloid in the brain
• 09:00 — Testing: fasting insulin and what it tells you about amylin
• 10:00 — Meds that can help indirectly
• 14:00 — Why pramlintide (Symlin) is rarely used now
• 15:00 — Food first: fiber, plants, and lowering insulin demand
• 17:00 — Fruit vs. juice, and not “gorging”
• 18:00 — Time-restricted eating: 12/12 or 10/14 (not extreme)
• 21:00 — Spread carbs through the day to blunt spikes
• 26:00 — Anti-inflammatory foods and omega-3s
• 27:00 — Move more: walking, strength, and cardio
• 28:00 — Don’t obsess over the scale; focus on habits
• 32:00 — Sleep and stress make IAPP toxicity worse
• 33:00 — “Overnutrition” = too many calories + inactivity
• 35:00 — Closing: take courage; you can do this

The Big Idea (in plain English)

Amylin (also called IAPP) is a partner hormone to insulin. Your pancreas releases both together.

In small amounts, amylin helps:

• Slow stomach emptying (you feel full longer)
• Lower glucagon when insulin is present
• Smooth out after-meal blood sugars

In insulin resistance, your body makes more insulin — and more amylin. Too much amylin can misfold, clump, and create amyloid “plaques” inside the islets (where beta cells live).

These plaques are toxic. They damage beta cell membranes, trigger inflammation, and lead to beta cell death. Over time, you lose insulin-making power.

This starts early. It often begins before diabetes is diagnosed. In fact, up to 95% of people with type 2 diabetes have detectable islet amyloid at diagnosis.

Think of it like hair with knots: smooth strands are fine; tangled knots cause a mess. Misfolded amylin is the knot.

Why This Matters

• Islet Amyloid Polypeptide (IAPP) Toxicity is not just a symptom. It drives beta cell failure and speeds up type 2 diabetes.
• It looks a lot like the amyloid problem seen in the brain in Alzheimer’s (different place, similar kind of misfolding trouble).

How To Test

• Ask your doctor for a fasting insulin test.
• Because insulin and amylin are co-secreted, high fasting insulin usually means high amylin too.
• There isn’t a simple, routine blood test for amylin. Fasting insulin is your best early clue.

Medications We Talked About

There is no FDA-approved drug that “unfolds” or clears IAPP amyloid plaques yet. But some meds can lower the pressure on beta cells and reduce insulin demand:

GLP-1 receptor agonists (GLP-1 RAs)

• Lower glucagon, help with satiety, help reduce insulin demand
• Less insulin out = less amylin out
• May support beta cell survival indirectly

DPP-4 inhibitors

• A less powerful, pill-based incretin support
• Can lightly reduce insulin demand

TZDs (like pioglitazone)

• Improve insulin sensitivity
• May lower amylin production by lowering insulin needs

Pramlintide (Symlin)

• A synthetic amylin analog (injectable)
• Can slow stomach emptying, reduce post-meal glucagon, and help satiety
• Used far less now; can cause nausea; adds injection burden
• Does not fix Islet Amyloid Polypeptide (IAPP) Toxicity or clear plaques
• May be more relevant in type 1, where amylin can be low

Always work with your care team to decide what’s right for you.

Lifestyle: Your Daily Playbook

Goal: lower insulin demand and calm inflammation so you make fewer “knots” (misfolded amylin).

1. Eat to reduce insulin demand

• Focus on a whole-food, plant-forward pattern:
  • Fiber: aim for 25–35+ grams/day
  • Colorful fruits and veggies (5–9 servings/day if you can)
  • Lots of non-starchy vegetables (greens, broccoli, peppers, etc.)
  • Lower glycemic load foods
• Fruit vs. juice:
  • Whole fruit is great; juice spikes fast
  • Don’t “gorge,” but it’s hard to overdo whole fruits/veggies because of fiber and water
• Anti-inf