what The *&^% !

[trailrunner]

Ok so I have just started on symlin, for the past two days. I am using 10 units with meals. I watch my diet pretty closely, I almost never have to bolus for meals, usually the 10 units of lantus is all I need. I usually have a small spike post meals but with in 2 hours I am in a normal range without any additional insulin. My endo gave me the symlin to try to see if it stops the spikes. So any way long story short ... I ran 10 miles this morning, took my lantus after, symlin 20 mins prior to my meal of a lean cuisine pizza and 1/2 cup of ice cream,(60 carbs plus or minus) and 2 full hour later my bs was 255! I have NEVER been this high before ! Not even at dx ( 230 at DX) so my question is What happened?

[Emm]

Had you tried pizza before you had the symlin? I know pizza has the potential to raise my BG for hours.

And ice cream has the same effect on me. Perhaps it was just those two foods in one meal that stuffed it?

Does exercise usually lower your numbers? Sometimes it can do the opposite, depending on the intensity of the exercise, and how high you were to start with.

Did you test before you ate? Could you have been high already?

One last question... You said you don't often have to bolus - not even for a meal like that? I'd be surprised if a T1.5 could get away with anything like that without at least some short-acting insulin.

[Cyborg]

What was your bg after exercising, but before eating? Did you take insulin for your food? Symlin is not a substitute for insulin.

[David_S]

Sounds like a ton of carbs to me. I eat about 45 at the most.. novolog with dinner .

[BlueSky]

.... I ran 10 miles this morning, took my lantus after ... and 2 full hour later my bs was 255! I have NEVER been this high before ! Not even at dx ( 230 at DX) so my question is What happened?
trailrunner,

You could have run out of insulin when you were exercising. It was nearly 24 hours after your last Lantus shot. And you only injected 10 units (the bigger the shot, the longer it lasts). Insufficient circulating insulin during exercise would have caused a lot of glycogen to be released. Which could explain the surge in BG. If this happens again after exercise, you may have to consider changing the amount/timing of your Lantus.

Symlin and Lantus is a curious regimen for a T1.5, to say the least. The beta cells that are still producing a lot of endogenous insulin should also still be producing Amylin. Symlin is far more useful for long-time T1s with totally defunct beta cells. And I am surprised that your endo would choose it over insulin.

The challenge really is to supply supplemental insulin where it is needed most. And in your case, that is probably after meals. So, IMHO, it would make much more sense for you to drop the Symlin, do mealtime insulin boluses, and only inject as much Lantus as you need to keep between-meal BG down. :wink:

[Cyborg]

Symlin is not a substitute for insulin. They work together...

[trailrunner]

Had you tried pizza before you had the symlin? I know pizza has the potential to raise my BG for hours.

And ice cream has the same effect on me. Perhaps it was just those two foods in one meal that stuffed it?

Does exercise usually lower your numbers? Sometimes it can do the opposite, depending on the intensity of the exercise, and how high you were to start with.

Did you test before you ate? Could you have been high already?

One last question... You said you don't often have to bolus - not even for a meal like that? I'd be surprised if a T1.5 could get away with anything like that without at least some short-acting insulin.
Exersize does lower my numbers uusally, the ten miles was a easy run for me. when I started running that day my was bs was 91. I finished at 129. I have been honeymooning for quite a while. I think that is the end of it.

[MJM]

:eek: A half cup of ice cream is certainly going to shoot up your bs and keep it up. It would for me. Ice cream is a high Glycaemic Index food (rating 61)and consequently it's going to shoot your bs up. Pizza is also a high GI food (rating 60 ). So you can imagine what both of them together will do. Here's a hint. If you eat a high GI food and a low GI food together you will end up with only a medium GI food. Worth considering.

[kidvid]

For some people it takes a few weeks before Symlin has the desired effect. I have been on it twice, this last time for about 7 months. It took me a couple weeks of moderate highs (225-250) before it had the desired effect. It now knocks 50 points off my highs breakfast and lunch every day! I never use it if I don't need insulin, and never if I don't eat 30 grams of carbs. I usually use it for about 40 grams.

Joe