Got Some Symlin Today

[Cyborg]

My endo wrote me a script for Symlin and also gave me a vial and the starter kit. Also got a Novalog pen and vial of Novalog. I think he was pleased with my 6.2 a1c. :)

So... I got this Symlin here, and I was kinda lookin for some tips, advice, what-to-expects. It says not to take any if I eat less than 30 grams of carbs. Also says to take 1/2 of my insulin. I guess that means 1/2 of my bolus since I'm a pumper. :hmmmm2:

[duck]

You're gonna feel queeeeeeeeeasy...

[Cyborg]

You're gonna feel queeeeeeeeeasy...

That's what it says. I'm not known for getting nauseous, but I guess this is pretty strong stuff. Not sure if my pancreas has been creating any amylin in a while. One way to find out!

[duck]

It goes without saying, but proceed with caution. I've read nothing but good stuff so far.

[Cyborg]

It goes without saying, but proceed with caution. I've read nothing but good stuff so far.

I'm half way there, I found 30 carbs for dinner. Good thing they supplied some smaller needles with the starter kit.

[middnite03]

the best advice.... COMBO BOLUS!!!... when I take it before lunch and supper... I have to take a combo bolus (dual wave for MM) about 40 percent now, and 60 percent over 2 hours.... it takes some time to get used to, and it can drive you nuts,. but once you get into the program with it, it's great!!!

[psilocybin]

im having a hard time figuring out what this symlin is

[Cyborg]

the best advice.... COMBO BOLUS!!!... when I take it before lunch and supper... I have to take a combo bolus (dual wave for MM) about 40 percent now, and 60 percent over 2 hours.... it takes some time to get used to, and it can drive you nuts,. but once you get into the program with it, it's great!!!

Did you still cut your bolus dosage in half when you started?

[JediSkipdogg]

im having a hard time figuring out what this symlin is

It's a drug like insulin that reduces the peaks you get from food. It also is suppose to reduce your overall need for insulin and you work in steps to the standard dose. Once you hit that dose you take it every major meal and it helps to eliminate any peaks in that meal. www.symlin.com is the website.

[psilocybin]

is it better than insulin?

[JediSkipdogg]

is it better than insulin?

It's taken with insulin (not mixed with it) and the dose amount is standard, meaning you don't change it with what your sugar level or what you eat is.

[spike]

My endo wrote me a script for Symlin and also gave me a vial and the starter kit. Also got a Novalog pen and vial of Novalog. I think he was pleased with my 6.2 a1c. :)

So... I got this Symlin here, and I was kinda lookin for some tips, advice, what-to-expects. It says not to take any if I eat less than 30 grams of carbs. Also says to take 1/2 of my insulin. I guess that means 1/2 of my bolus since I'm a pumper. :hmmmm2:

What is the advantage of using this stuff in lieu of the normal amount of insulin? doesn't this just introduce another variable? what's the up side? there must be one, but I don't see it. Please explain if the pro's outweigh the cons. I don't like making things more complicated than they need to be, which is why I like being a T1 with one thing to take for my bg's, instead of all the pills that T2's pop.

[JediSkipdogg]

What is the advantage of using this stuff in lieu of the normal amount of insulin? doesn't this just introduce another variable? what's the up side? there must be one, but I don't see it. Please explain if the pro's outweigh the cons. I don't like making things more complicated than they need to be, which is why I like being a T1 with one thing to take for my bg's, instead of all the pills that T2's pop.

The upside is for those that get extreme BG peaks with eating food. It levels those peaks out. For me, no matter what I eat, my BG level will peak about 100 mg/dl 90 minutes after a meal. I go above 200 quite often even if my pre-meal was around 110. Eliminating those peaks alone can drop an A1C a good amount, maybe 0.5 - 1.0%.

It is also suppose to reduce one's total need for insulin. For someone taking 100+ units a day it may help them use less insulin which could help them spend less money.

But the ultimate use is for leveling BGs out.

[Cyborg]

Keep in mind that insulin is termed the "fat drug". My endo today says to consider the Symlin sort of the opposite in that effect. It should cut the spikes in bg after eating and it should reduce insulin usage, which is a good thing for someone trying to lose weight.

I've been having problems with keeping my bg down not because of lack of exercise or what I'm eating, but because I'm losing weight. I've seen some horrible numbers, 270's and such, for no other reason than eating a medium carb / low calorie meal while in this weight loss mode. Hopefully the Symlin will help in this manner also.

I couldn't have picked a better day to start the Symlin. Having the CGMS connected it is very interesting watching the numbers live. I ate dinner 1/2 hour ago. I had 42 grams of carbs and about 460 calories. I took only 2 1/2 units of Symlin. My sugar was 88 when I took the Symlin and boluses only 1/2 of my normal insulin dosage. My bg has decreased ever since. I've got a belly full of food and my bg seems to be heading south still. I'm currently at 81... :hmmmm:

No nausea, unless the little twinges I feel in my stomach are what is considered nausea for this medication. I don't feel like I need to upchuck or anything. :puke:

[Cyborg]

When taking the Symlin, I know I'm supposed to take 1/2 of my normal meal bolus. Does this also apply to the 2 hour correction bolus?

[spike]

Keep in mind that insulin is termed the "fat drug". My endo today says to consider the Symlin sort of the opposite in that effect. It should cut the spikes in bg after eating and it should reduce insulin usage, which is a good thing for someone trying to lose weight.

I've been having problems with keeping my bg down not because of lack of exercise or what I'm eating, but because I'm losing weight. I've seen some horrible numbers, 270's and such, for no other reason than eating a medium carb / low calorie meal while in this weight loss mode. Hopefully the Symlin will help in this manner also.

I couldn't have picked a better day to start the Symlin. Having the CGMS connected it is very interesting watching the numbers live. I ate dinner 1/2 hour ago. I had 42 grams of carbs and about 460 calories. I took only 2 1/2 units of Symlin. My sugar was 88 when I took the Symlin and boluses only 1/2 of my normal insulin dosage. My bg has decreased ever since. I've got a belly full of food and my bg seems to be heading south still. I'm currently at 81... :hmmmm:

No nausea, unless the little twinges I feel in my stomach are what is considered nausea for this medication. I don't feel like I need to upchuck or anything. :puke:


thanks for all that info--sounds interesting. Now how about a Mexican meal or pizza? would you still do an extended bolus ( I do a 4 hour extended for pizza. I've been avoiding Mexican lately to avoid long term hypers) If I could take that stuff without getting nauseous, I'd consider it.

I can't recall if anyone said insurance covers it. (My memory is the pits!)

[spike]

When taking the Symlin, I know I'm supposed to take 1/2 of my normal meal bolus. Does this also apply to the 2 hour correction bolus?

Does symlin cause gas or bloating?

[Cyborg]

No ill effects at all. A few stomach twinges, but no nausea or upset stomach or gas, etc. My sugars did not move for nearly 1 1/2 hours after eating. If anything they dropped slightly during that period. It's about 2 1/2 hours after eating now and I don't know whether to do a correction bolus and if so, whether to do it at 1/2 dosage???

I got a free vial today, but I think insurance does cover Symlin.

[Shotokan]

I've been using Symlin for a while and my insulin reduction varied from one meal to another. I had to figure out my I:C ratios all over again (starting with 1/2 my usual I:C ratio).

Symlin potentiates insulin. I had to stop taking it for lunch because my BG would always go low afterward. One day my BG was at 113, I took 10 units of Symlin, ate 60 carbs for lunch, and did not bolus any insulin (I forgot). One hour later, my BG had dropped 40 units. Without bolusing any insulin! Apparently, it potentiated my basal insulin. However, my BG was at 160 two hours after lunch and I had to correct that. So my endo told me to nix the Symlin at lunchtime.

I think Middnite03 is on the right track with the combo bolus. Yeah, it does make things more complicated, but as JediSkipDogg says, it does even out those post-meal highs. My after breakfast BG never breaks 140 any more.

Supposedly, Symlin also acts as an appetite suppressant, which in combination with insulin reduction should aid in weight loss. It's effect in that regard has been very mild for me. I still feel hungry all the time and I'm not losing much weight.

[Cyborg]

I've been using Symlin for a while and my insulin reduction varied from one meal to another. I had to figure out my I:C ratios all over again (starting with 1/2 my usual I:C ratio).

Symlin potentiates insulin. I had to stop taking it for lunch because my BG would always go low afterward. One day my BG was at 113, I took 10 units of Symlin, ate 60 carbs for lunch, and did not bolus any insulin (I forgot). One hour later, my BG had dropped 40 units. Without bolusing any insulin! Apparently, it potentiated my basal insulin. However, my BG was at 160 two hours after lunch and I had to correct that. So my endo told me to nix the Symlin at lunchtime.

I think Middnite03 is on the right track with the combo bolus. Yeah, it does make things more complicated, but as JediSkipDogg says, it does even out those post-meal highs. My after breakfast BG never breaks 140 any more.

Supposedly, Symlin also acts as an appetite suppressant, which in combination with insulin reduction should aid in weight loss. It's effect in that regard has been very mild for me. I still feel hungry all the time and I'm not losing much weight.

Any idea what the duration of the Symlin is? How long does it stay in my body interacting with any additional insulin?

[condensr]

Interesting..

I was just reading up on the symlin website, and it said that Symlin works by slowing the emptying of food from the stomach.

I get pretty decent peaks from meals, especially lunch. If it were not for the fact that I just got on a pump to reduce the amount of injections I need (at least that was one reason..) I'd consider it myself.

[jeggeman31]

I can't recall if anyone said insurance covers it. (My memory is the pits!)
I just checked United Health Care (my insurance company) website and it is a covered drug for me. I would think most insurances would cover it.

I go back to my Endo next month and we will be talking about this then for me.

[Shotokan]

Any idea what the duration of the Symlin is? How long does it stay in my body interacting with any additional insulin?

My CDE told me that it lasts as long as 3 or 4 hours. She also told me that I should take it at least 15 minutes prior to eating for maximum effect and that I shouldn't bother to take it after my meal (if I forget to take it before).

[Cyborg]

My CDE told me that it lasts as long as 3 or 4 hours. She also told me that I should take it at least 15 minutes prior to eating for maximum effect and that I shouldn't bother to take it after my meal (if I forget to take it before).

I also saw mention of the fact that Symlin can cause a low up to 3 hours after taking it. It seems like my bg has leveled out, so I'm going to do a full strengh correction bolus.

Not bad, I peaked out at about 150. I'm impressed for taking only 2.5 units of insulin to cover 42 carbs.

[spike]

Interesting..

I was just reading up on the symlin website, and it said that Symlin works by slowing the emptying of food from the stomach.

I get pretty decent peaks from meals, especially lunch. If it were not for the fact that I just got on a pump to reduce the amount of injections I need (at least that was one reason..) I'd consider it myself.

Does that mean that Symlin is creating a sort of gastroparesis effect? I know that sounds like a stupid question, but isn't GP a slowing of the digestion, starting with the stomach emptying slower than normal? Don't laugh! I'm trying to understand by what process Symlin is working to reduce post prandial bg's and I'm only getting my information from you guys on this thread. I haven't read up on it or GP anywhere else so I'm totally in the dark about these 2 subjects.

[condensr]

Spike, yes, something like that. Here's a quote on the action of Amylin (the hormone that us diabetics are deficient in) and Symlin (the artificial replacement).



SYMLIN slows gastric emptying
SYMLIN suppresses postprandial glucagon secretion leading to suppression of endogenous glucose output from the liver
SYMLIN modulates appetite by enhancing satiety. This effect is independent of nausea and may lead to weight loss

[middnite03]

spike, I had to reduce my bolus by about 30 to 40 percent when I got to the full dose, and again I extend that bolus for 2 to 2.5 hours.... now after a meal I peak at maybe 140 to 150, when before I used to peak at over 200.... I eat alot less, and have lost a total of 20 pounds so far... my tdd of insulin was between 100 and 120, now it's at 75 to 95... but this could be becuase of the weight loss also.. What I can tell you is this, it works differently for everyone, just like everything else in the $#!t condition. it will take you time to master using it, and alot of patients..... just make sure you check quite often, and have glucose tabs colse at hand... the biggest problem I had in the beginging, was learning to use the combo bolus.... I would go low an hour after a meal then shoot up an hour later on. for me it seems to work for about 2 to 3 hours... and as you increase the dosage, remember to reduce the now part of your combo bolus, and increase the time on the extended part of your bolus.... but I will say this, with all the problems I had getting used to it, and all the time I had to put into it to learn exactly how change my insulin ranges and time, the end result was well worth it for me......... took my a1c down 1.5 % and I have never in my life had better control og my BG's.....

there is also talk about symlin comming out with a pen, it's in for fda app right now, and they are talking about a once a day shot, and a once a week shot also..... but that will take alot longer to come out then the pen......

just remember to keep checking bgs and smile :proud:
because untill you get used to it, and learn how to use it best you will do this....... -------> :banghead:

[tstevenson911]

I have been on Symlin for about 3 months now, and I did not have any nausea at first. I know of a person that could not handle the drug, but I haven't had any nausea - NONE... and I have lost about 12 pounds as well.

I noticed that it reduced my mealtime bolus by about 20-25% and my correction bolus by 20-25% also. Watch your basal rates as I was finding myself low when I normally had the after mealtime highs < two hours after eating and also middle of the night>. I frequently use the combination bolus 50/50 or 60/40 for 30 to 60 minutes. I take my symlin 10-20 minutes prior to food and bolus afterwards. I get my A1c checked the 1st week of May, and cannot wait to see the results. Usually I am about 7.2. I would bet that I am mid 6's.

I cheked my insulin usage this morning <daily amounts>, and also noticed that I haven't used near the amounts of correction boluses that I used prior to symlin.

I do not look forward to the shot (I gave those up when I went to the Cosmo two years ago, and love it), but I think the benefits outweigh the hassle.

Best of luck.

[Cyborg]

So far, so good... 2 days and no nausea at all. I've definately seen it working. Amazing how it decreases the insulin requirements. Trying to find that perfect percentage of my normal dosage now and starting to play with combo boluses.

How often did you up your dose of Symlin and when did you reach your max dosage? How do you know when you've reached your max?

Thanks

[tstevenson911]

I followed the instructions on the card in the Symlin box. I would not stray from those instructions.

[Cyborg]

It appears 60 mcg is the max dosage for type 1's and 120 mcg is the max dosage for type 2's. Looks like this is considered the maintenance dose assuming there is no nausea.

[tstevenson911]

I am taking 10 units prior to eating 3 times a day. again, never nausea.

[Cyborg]

I am taking 10 units prior to eating 3 times a day. again, never nausea.

60 mcg = 10 units, so you are taking the max dosage per meal. I assume you are eating 30 grams / 300 calories per meal when you take it.

[JediSkipdogg]

Now do you have to stick to a certain eating regimin on it or can you still eat what you want, just as long as it's over that 30/300 number?

[Cyborg]

Now do you have to stick to a certain eating regimin on it or can you still eat what you want, just as long as it's over that 30/300 number?

With regards to what you eat, the literature only says to ensure you eat 30g carbs and 300 calories minimum if you are going to take it, otherwise do not take the Symlin.

[Jorj Gaidin]

Perhaps someone could post some clarification. I had never heard of this drug until reading about it on this forum. I understand how it works... but not exactly who is meant to take it. Is it only a certain group of diabetics or should all be taking it? Also, does anyone know if there are any long-term complications from using this? I mean nothing is 100% safe right?

[JediSkipdogg]

Perhaps someone could post some clarification. I had never heard of this drug until reading about it on this forum. I understand how it works... but not exactly who is meant to take it. Is it only a certain group of diabetics or should all be taking it? Also, does anyone know if there are any long-term complications from using this? I mean nothing is 100% safe right?

Symlin should be taken by anyone that wants to lower their A1C level and help bring their levels into a tighter control. It should also be taken for those that want to counter a major side effect of insulin and that is weight gain.

More info can be found at thier website including the side effects. All the links are on the left hand side.

http://www.symlin.com/210AboutSymlin.aspx

[Cyborg]

With regards to what you eat, the literature only says to ensure you eat 30g carbs and 300 calories minimum if you are going to take it, otherwise do not take the Symlin.

That was supposed to be 30g carbs and 250 calories.

[Cyborg]

Tried an interesting experiment tonight with the Symlin. Seemed to have perfect results with it. I've mentioned a few times how I normally bolus for high protein meals such as a steak or shrimp. Tonight I decided to take my Symlin before eating my steak dinner. I usually take 50% of the protein content as carbs and do a 30/70 combo bolus over 3 hours.

I calculated the carbs as 50% of the protein as I usually do. I then entered my bg and the carb value into the pump to get a suggested insulin dosage for my bolus. At this point, since I was taking Symlin, I multiplied that dosage by 0.6 (representing 60%) to come up with the amount of insulin to bolus.

Now I still wanted to do a 3 hour combo bolus, but I knew that the Symlin would slow initial digestion based on past experience so I reduced the initial part of the ratio by 50% so I did a 3 hour 15/85 combo bolus rather than a 3 hour 30/70 combo bolus. It has been nearly 4 hours since I've eaten and my bg has not budged more than 5 points! I love it when experiments like this work out. :)

I guess I broke a Symlin rule though, I ate zero real carbs. :whistling But then again, no one ever talks about equivalent carbs...

[spike]

Tried an interesting experiment tonight with the Symlin. Seemed to have perfect results with it. I've mentioned a few times how I normally bolus for high protein meals such as a steak or shrimp. Tonight I decided to take my Symlin before eating my steak dinner. I usually take 50% of the protein content as carbs and do a 30/70 combo bolus over 3 hours.

I calculated the carbs as 50% of the protein as I usually do. I then entered my bg and the carb value into the pump to get a suggested insulin dosage for my bolus. At this point, since I was taking Symlin, I multiplied that dosage by 0.6 (representing 60%) to come up with the amount of insulin to bolus.

Now I still wanted to do a 3 hour combo bolus, but I knew that the Symlin would slow initial digestion based on past experience so I reduced the initial part of the ratio by 50% so I did a 3 hour 15/85 combo bolus rather than a 3 hour 30/70 combo bolus. It has been nearly 4 hours since I've eaten and my bg has not budged more than 5 points! I love it when experiments like this work out. :)

I guess I broke a Symlin rule though, I ate zero real carbs. :whistling But then again, no one ever talks about equivalent carbs...

Do the makers of Symlin have tech support?

[Cyborg]

Do the makers of Symlin have tech support?

They do have a customer support number listed in the docs that come with the starter kit. The number is 1-800-349-8919.

I just hand some left over steak from last night for lunch, so I'm repeating the experiment to verify the results.

[Cyborg]

Tried an interesting experiment tonight with the Symlin. Seemed to have perfect results with it. I've mentioned a few times how I normally bolus for high protein meals such as a steak or shrimp. Tonight I decided to take my Symlin before eating my steak dinner. I usually take 50% of the protein content as carbs and do a 30/70 combo bolus over 3 hours.

I calculated the carbs as 50% of the protein as I usually do. I then entered my bg and the carb value into the pump to get a suggested insulin dosage for my bolus. At this point, since I was taking Symlin, I multiplied that dosage by 0.6 (representing 60%) to come up with the amount of insulin to bolus.

Now I still wanted to do a 3 hour combo bolus, but I knew that the Symlin would slow initial digestion based on past experience so I reduced the initial part of the ratio by 50% so I did a 3 hour 15/85 combo bolus rather than a 3 hour 30/70 combo bolus. It has been nearly 4 hours since I've eaten and my bg has not budged more than 5 points! I love it when experiments like this work out. :)

I guess I broke a Symlin rule though, I ate zero real carbs. :whistling But then again, no one ever talks about equivalent carbs...

I verified the experiement today with the same success. My bg had a small rise up to about 140 at about the 3 hour mark, but then by the 5 hour market was right back on target.

I think I lke Symlin. :)

[Shotokan]

Here is a very informative article on Symlin:

http://www.diabetesselfmanagement.com/article.cfm?SSL=n&AID=2157&SID=2&TID=42&SK=9AAK&page=1