Islet Amyloid Polypeptide (IAPP) Toxicity: What It Is, Why It Matters, and What You Can Do

“There’s no FDA-approved drug that clears out misfolded IAPP, but we can lower insulin demand and protect beta cells.”

Welcome to The Diabetes Podcast blog, where we cut through confusion, spotlight the science, and give you real tools to take control of your blood sugar. Today we’re unpacking a lesser-known but critical piece of the type 2 diabetes puzzle: Islet Amyloid Polypeptide (IAPP) toxicity. You might also hear it called amylin or amyloid buildup in the pancreas.

This is about what happens inside your beta cells—the cells that make insulin. When IAPP goes wrong, it hurts those cells from the inside out. We’ll explain normal physiology, what breaks, which medications can help indirectly, and what lifestyle strategies make a real difference.

What Is Amylin (IAPP) in a Healthy Body?

• Amylin is a companion hormone to insulin. Your pancreas releases both at the same time.

• In small, normal amounts, amylin:

  • Slows gastric emptying (food leaves the stomach more slowly).

  • Lowers glucagon after meals (so your liver doesn’t dump extra sugar).

  • Helps you feel full (satiety).

  • Fine-tunes post-meal blood sugar.

Important note: People often compare amylin’s effects to GLP-1 drugs. It’s better to say GLP-1 receptor agonists can mimic some effects that your body naturally does with amylin.

When Things Go Wrong: IAPP Toxicity

• In insulin resistance, your body demands more insulin. When insulin goes up, amylin goes up too (they’re co-secreted).

• Too much amylin can misfold (think knots in hair). Misfolded IAPP forms sticky amyloid plaques inside and around beta cells.

• These plaques:

  • Damage beta cell membranes.

  • Trigger inflammation.

  • Lead to programmed cell death (beta cell loss).

  • Reduce insulin production over time.

This isn’t just a symptom—it drives disease progression. Research shows up to 95% of people with type 2 diabetes have amyloid deposits in their islets at diagnosis. And it likely begins years before diagnosis, during the hyperinsulinemia stage.

A Helpful Picture

• Brain vs. pancreas: Protein misfolding and amyloid buildup can happen in both places. In the brain, it can link to memory loss. In the pancreas, it leads to loss of insulin-making cells.

Testing: Do I Need an Amylin Test?

• You usually don’t need a separate amylin test.

• Because amylin and insulin are co-secreted, high fasting insulin strongly suggests high amylin.

• Action step: Ask your provider for a fasting insulin test to see where you are on the path.

Medications: What Helps (Indirectly)

There’s no FDA-approved drug that “unfolds” IAPP or clears amyloid in the pancreas. But some meds can lower stress on beta cells and reduce IAPP burden indirectly by lowering insulin demand.

GLP-1 receptor agonists (e.g., semaglutide, liraglutide):

• Decrease glucagon.

• Reduce insulin demand.

• Improve satiety and post-meal control.

• May enhance beta cell survival by reducing new IAPP buildup.

DPP-4 inhibitors:

• A milder, oral incretin option.

• Can help with post-meal control and reduce insulin demand a bit.

TZDs (e.g., pioglitazone):

• Improve insulin sensitivity.

• Lower insulin and amylin secretion needs over time.

Pramlintide (Symlin):

• A synthetic amylin analog (injection).

• Approved for type 1 and type 2.

• Can slow gastric emptying, reduce post-meal glucagon, and promote satiety.

• Downsides: extra injections (often 2/day), nausea, careful titration.

• It does not fix IAPP toxicity or clear amyloid. It’s used less often today, and more helpful when amylin is deficient (like in type 1), not overproduced.

Lifestyle: What You Can Do (That Really Works)

Goal: Reduce insulin demand and oxidative stress. This eases pressure on beta cells and lowers the chance of IAPP misfolding and buildup.

Eat for lower insulin demand

• Favor a whole-food, plant-forward pattern:

  • High fiber: Aim for 25–35+ grams/day.

  • High phytonutrients: Colorful fruits and vegetables.

  • Low glycemic load: Emphasize non-starchy veggies.

• Fruit vs. veggies:

  • Most people don’t hit 5–9 servings/day total. Aim there first.

  • Once you’re consistent, lean more on non-starchy vegetables for lower glycemic impact.

  • Whole fruit is generally fine; avoid juices which spike sugar quickly.

• Anti-inflammatory, antioxidant-rich foods:

  • Dark berries, green tea, and dark leafy greens (spinach, kale).

  • Omega-3s (e.g., fatty fish, walnuts, flax, chia) to support cell membranes and calm inflammation.

• Spread carbs across meals:

  • Avoid one giant carb-heavy meal. Spacing helps prevent big spikes.

Time-restricted eating (simple version)

• Human data is mixed, but for IAPP stress, giving your pancreas breaks makes sense.

• Choose a gentle, sustainable window:

  • 12:12 or 10:14 (eating:fasting) are reasonable for many people.

  • Try an earlier dinner if possible.

  • Avoid extreme windows that trigger overeating or poor choices.

Move your body (consistently)

• Start with walking if you’re mostly sedentary.

• Build toward:

  • Aerobic exercise for insulin sensitivity.

  • Resistance/weight-bearing training to improve muscle mass and glucose disposal.

• Don’t obsess over the scale.

  • Focus on body composition, strength, energy, and consistency.

  • Visceral fat around the midsection is the bigger concern—moving more and eating better will help.

Sleep and stress

• Poor sleep and high stress raise cortisol and worsen insulin resistance.

• Aim for a steady sleep schedule and stress tools that work for you (walks, breathwork, simple routines).

• These small wins stack up.

Mind the “SAD” combo

• The Standard American Diet (high fat, high sugar, highly processed foods) plus inactivity boosts IAPP toxicity—even before blood sugar rises.

• Cut back on added sugars and ultra-processed foods. Start small and keep going.

Simple Action Plan

• Ask your provider for a fasting insulin test.

• Add 1–2 servings of non-starchy vegetables today.

• Replace juice with whole fruit.

• Walk 10–15 minutes after meals.

• Try a 12:12 eating window for two weeks.

• Add a short resistance routine twice a week (bodyweight counts).

• Aim for a consistent bedtime and wake time.

Key Takeaways

• Islet Amyloid Polypeptide toxicity is real and harmful to beta cells.

• It often begins years before diabetes is diagnosed.

• There’s no direct “amyloid clearing” drug yet, but you can lower IAPP stress:

  • Reduce insulin demand with food choices, movement, sleep, and stress care.

  • Consider medications that support beta cells by easing insulin demand.

• You don’t need perfection. You need consistency.

You’re Not Alone

If this sparked curiosity or gave you clarity, share it with someone who needs it. And if you’re ready to get off the blood sugar rollercoaster and walk a real path to remission—with expert guidance and big support—contact us at [email protected].

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The information in this blog post and podcast is for educational and informational purposes only. It is not medical advice, diagnosis, or treatment, and it does not replace a one-on-one relationship with your physician or qualified healthcare professional. Always talk with your doctor, pharmacist, or care team before starting, stopping, or changing any medication, supplement, exercise plan, or nutrition plan—especially if you have diabetes, prediabetes, heart, liver, or kidney conditions, or take prescription drugs like metformin or insulin.

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