New on symlin. Already got a question.....

[lelggren]

Hi! I just got my first little bottle of symlin today. I start taking it tonight. And, I just have a question or several. Ok, so you are supposed to cut your meal ratio in half. So, then in my pump, do I just change the one ratio that I had set already (1:6 goes to 1:12)? What ratio do I use for when I have a snack? Do I use the 1:6 ratio when I am eating something that is less than the 30 carb "must take symlin" limit?

Thank you:trytofly:

[koblenz]

Welcome to the cult of the little Symlin bottle! :D

I don't know about everyone else, but I don't mess with my pump settings, I just half my number of carbs and enter that in the pump. Yes that alters my reports of total carbs eaten.

... of course I only need it for breakfast, and sometimes I skip it all together if I have a small breakfast or if I am going for a long drive right after eating.

Good luck and I hope it works as well for you as it does for me!

[lelggren]

Welcome to the cult of the little Symlin bottle! :D

I don't know about everyone else, but I don't mess with my pump settings, I just half my number of carbs and enter that in the pump. Yes that alters my reports of total carbs eaten.

... of course I only need it for breakfast, and sometimes I skip it all together if I have a small breakfast or if I am going for a long drive right after eating.

Good luck and I hope it works as well for you as it does for me!
I went into my pump and did my insulin/carb ratio according to when I eat, and I just halfed it at the times when I normally eat a meal. But, this concerns me because what if I eat a meal at a non-typical time? Then, I am risking going low. I don't really download my pump and so it is ok if the grams intake data is a bit off. I'm not worried about that. Maybe I'll try it like you do it. Thanks!! Any other feedback on Symlin and it's working or failing for you would be great. I'm my dr's first patient to go on it, and so he didn't really have much feedback on the in's and out's of it.

[psilocybin]

question...u guys have to take an injection for symlin plus your boluses for pumping?

[duck]

question...u guys have to take an injection for symlin plus your boluses for pumping?

Yeah, you need to bolus and inject symlin...My understanding is you can forego the symlin if you wish and take a "normal" bolus. Or take the symlin and do your I-just-took-symlin-bolus.

But I have a question (and sorry if I derail this topic, just punch me later): Can you go hypo just with taking symlin and no bolus (assuming you eat no food or not enough food)?

[Cyborg]

Hi! I just got my first little bottle of symlin today. I start taking it tonight. And, I just have a question or several. Ok, so you are supposed to cut your meal ratio in half. So, then in my pump, do I just change the one ratio that I had set already (1:6 goes to 1:12)? What ratio do I use for when I have a snack? Do I use the 1:6 ratio when I am eating something that is less than the 30 carb "must take symlin" limit?

Thank you:trytofly:

I started Symlin about 2-3 weeks ago. What I've been doing is putting the carb content and current blood glucose into the pump along with the ISF and carb ratio (depending on my current metabolism) then let the wizard suggest to me how much insulin to take. I then take 60% of this number and bolus it over 2 hours with a 40/60 combo bolus. That seems to work well for me with a normal meal (non-high-protein meal).

BTW, I started a Symlin thread because I also have some questions to knock around with you fellow Symlin users. It's here (http://www.diabetesforums.com/other-medications/9447-symlin.html) if anyone wants to participate.

[Cyborg]

Can you go hypo just with taking symlin and no bolus (assuming you eat no food or not enough food)?

I think you can go low if you just take Symlin and no bolus, but not positive. They say to only take Symlin if you are going to eat 30g of carbs and 250 calories so that's why I am assuming you can go low with Symlin alone. I did try to call the support line once for some answers but only got the offer for a callback the next day. I was either not home the next day when they called but did not leave a message, or they never did call.

[koblenz]

Can you go hypo just with taking symlin and no bolus (assuming you eat no food or not enough food)?
I don't know either, never tried. As the Symlin is supposed to "work" on digestion, logic would suggest no. But, I don't know what "other things" it affects, so the answer could be yes I suppose.

I have a regularly scheduled checkup with my Endo this Friday morning, I will add this to my list of "gee whiz" questions to ask. My Endo loves it when I come in with a list of questions!

:topic:
My Endo has been training new interns my last few visits, and he usually sends them in to give me the once over before he comes in. He asked me if I mind this, and I said no, they all have to learn some time.

The interns usually ask me if I have any questions, and I LOVE to hit them with these esoteric questions. They get this deer in the headlights look, note it down, and then say that we can ask my endo when he comes in. My endo will come in with the intern, the interns notes, he reads the questions, looks at me and grins and proceeds to ask the intern "so what do you think about 'x' ". I get my answers and I get to watch an intern squirm. Oh, that never gets old! Ah ha ha ha ha ha ha

End :topic:

[Cyborg]

The interns usually ask me if I have any questions, and I LOVE to hit them with these esoteric questions. They get this deer in the headlights look, note it down, and then say that we can ask my endo when he comes in. My endo will come in with the intern, the interns notes, he reads the questions, looks at me and grins and proceeds to ask the intern "so what do you think about 'x' ". I get my answers and I get to watch an intern squirm. Oh, that never gets old! Ah ha ha ha ha ha ha


Oh Oh Oh! Ask them my Symlin questions. Please... Pretty Please...

[koblenz]

Oh Oh Oh! Ask them my Symlin questions. Please... Pretty Please...
Reply with your question and I will copy it to my list!

:evil: Muh ah ha ha ha ha ha

[soremom]

This doesn't really answer the question about going low if not eating enough carbs, but I have had a problem with the Symlin.

If I am in the low 70s or lower before eating, when I inject the Symlin I end up going low in the middle of the meal. This is before I do any boluses, I do them at the end of my meal. They seem to take extra long time to bring up also. The doctor told me to do less Symlin or forgo it if around that range. So far cutting back has helped. The hardest part for me is I loose my apetite when I am low and with having the Symlin in me hits even quicker. That makes it hard for me to get any more food in which why it takes so long to come back up. When this happens, I don't give any boluses until I see my bgs going above 120.

Just thought this may help. I don't know anyone else on this and the doctor had not heard of this reaction before so not sure if it is me or can happen to anyone.

Kim

[Cyborg]

This doesn't really answer the question about going low if not eating enough carbs, but I have had a problem with the Symlin.

If I am in the low 70s or lower before eating, when I inject the Symlin I end up going low in the middle of the meal. This is before I do any boluses, I do them at the end of my meal. They seem to take extra long time to bring up also. The doctor told me to do less Symlin or forgo it if around that range. So far cutting back has helped. The hardest part for me is I loose my apetite when I am low and with having the Symlin in me hits even quicker. That makes it hard for me to get any more food in which why it takes so long to come back up. When this happens, I don't give any boluses until I see my bgs going above 120.

Just thought this may help. I don't know anyone else on this and the doctor had not heard of this reaction before so not sure if it is me or can happen to anyone.

Kim

I thought I read in the starter kit not to take the Symlin if you were hypo or near hypo.

[Cyborg]

Reply with your question and I will copy it to my list!

:evil: Muh ah ha ha ha ha ha

You sound just like the real Butters on South Park! ;)

Ok, I copied my 2 questions over from the other thread:

I know we are supposed to ideally take our Symlin about 15 minutes prior to eating. Are we supposed to bolus (type 1's) at the same time as when we take the Symlin or when we start to eat? Or does the insulin timing depend upon our bg values?

Here's another... We are supposed take approximately 50% of our insulin dosage (as a starting %) while taking Symlin. Does this mean 50% of the insulin required to cover the carbs when we dose at meal time? Or does it mean 50% of the total meal time bolus (carb + correction)?

[psilocybin]

is symlin worth trying? how much does it actually help?

[Cyborg]

is symlin worth trying? how much does it actually help?

It's da kind!

Just kidding... It works really good. It cuts my meal bolus insulin needs by approx 40%. It does slow digestion, it levels the spikes due to eating and it does decrease appitite. The spike leveling I witnessed with the CGMS. Long term effects are still unknown for me. I'm still not up to the full dose and I don't take it with every meal since I still don't eat 30g carb with each meal yet. Hard to break old habits!

[Shotokan]

Can you go hypo just with taking symlin and no bolus (assuming you eat no food or not enough food)?

I did--sort of. As a result, my endo told me to stop using Symlin for lunch. My BG was about 110 before I ate lunch one day. I took 10 units of Symlin and ate 60 or 65 carbohydrates, then I forgot to take my insulin (normally would have taken about 5 units). My BG dropped 40 points in the first hour, then it bounced up to about 150 after 2 hours or so. I did a BG correction to bring it down from there.

However, Symlin has worked very nicely for breakfast and dinner, reducing my post-meal BGs. I haven't done combo boluses like Cyborg described, but it looks like it could be a good idea for some.

[Cyborg]

I haven't done combo boluses like Cyborg described, but it looks like it could be a good idea for some.

The combo boluses are pretty much required because of the big delay in absorbtion the Symlin causes. This I learned from another poster and by watching the CGMS. I actually watched my bg dip the first 1 1/2 hours after eating a plate of spaghetti which contained 72g carbs! So, if on MDI, I would extremely cautious with this stuff. Some have suggested even breaking your MDI boluses into 2 shots.

[lelggren]

Well kids, I have taken symlin at dinner last night, and at breakfast this morning. I noticed last night that this stuff kept my bg so much more steady! I checked before dinner, and I was 88. 1.5 hours later, I was 94 and another hour later, I was 96. I have never stayed that good and steady! I think that this is going to be good for me :thumbsup:

This morning, I woke up and I was 158, and I just tested and I am 206. But, that is actually less that my usual morning post prandial :) So, it's good! I'm usually 270's.

I'm on the 2.5 units dose at each "meal" and then it increases 2.5 units every 3 days until I am up to the full 10 units, and hopefully with no :puke: I'm not feeling sick yet though, so I think that is a good sign :)

I'll keep you all posted on my progress!

[koblenz]

You sound just like the real Butters on South Park! ;)

1498

Muh ah ha ha ha ha ha

[jak123]

It's da kind!
since I still don't eat 30g carb with each meal yet. Hard to break old habits!

I'm curious about this 30g carb level. Where does that come from? I'm new to diabetes but the doctor and all the books I've read to date have not mentioned this. THX, JAK

[Cyborg]

I'm curious about this 30g carb level. Where does that come from? I'm new to diabetes but the doctor and all the books I've read to date have not mentioned this. THX, JAK

It comes from the Symlin starter kit. From their own documentation...

[lelggren]

Ok, I have another question. So, I've been on the symlin for about 2.5 days now. And, I have noticed that when I eat, that I feel a much stronger "full" feeling than what I did before I started. It suprises me because I wonder, did I really not hardly ever feel full before this stuff? I have noticed that I eat quite a bit less because of this feeling. And, I know that it is supposed to do this for you, but I didn't think it would be this strong.

Did any of you feel it this strongly when you started on Symlin?

[koblenz]

Ok, I have another question. So, I've been on the symlin for about 2.5 days now. And, I have noticed that when I eat, that I feel a much stronger "full" feeling than what I did before I started. It suprises me because I wonder, did I really not hardly ever feel full before this stuff? I have noticed that I eat quite a bit less because of this feeling. And, I know that it is supposed to do this for you, but I didn't think it would be this strong.

Did any of you feel it this strongly when you started on Symlin?
Yes, it happened to me. I would get about half way through a meal and be like Uh!

With me, after about a month, the "stomach discomfort" went away, and after about 1.5 months, the "extreme full feeling" went away. Now I only take it at breakfast, so it may have taken longer for me to "adjust".

[Cyborg]

I get the same full feeling as well. It caught me off guard once or twice and since I had already bolused, I had to force myself to finish. Now I'm learning to eat smaller sized meals when I take the Symlin.

[lelggren]

Last night was really interesting with this because we went out for dinner. We went to Sizzler. Whenever we go there, we usually get a dinner, and the salad bar ( I love buffet style. So many choices!). But, we pig out on the salad bar, and then take the dinner home and use it the next day for lunch at work. Well, last night, I ate maybe half of what I would have eaten at that salad bar before I was so full that I thought I would have to be rolled out of there. All I had was a salad with cheese, a little ham, broccoli, and bleu cheese dressing, a cup of clam chowder, and a half of a piece of pizza. I usually am able to eat a lot more than that. I usually just eat a lot of salad because I love their choices. So, I make a couple of different theme salads....lol :) But, if you are going to pig out, they say veggies and salad is the way to go, right?? ;)

This symlin stuff is interesting......I can see now how one can lose weight on it.

[Cyborg]

And insluin is a fat drug. Less insulin equals less fat gain!

[lelggren]

And insluin is a fat drug. Less insulin equals less fat gain!
It's a beautiful thing! :)

[lelggren]

Another question. How long does it take for the 2 hours after eating reading to come all the way down to normal? Did your bg's kindof skip around a lot when you first started on Symlin?

[Cyborg]

Another question. How long does it take for the 2 hours after eating reading to come all the way down to normal? Did your bg's kindof skip around a lot when you first started on Symlin?

Approximately 4 hours when bolusing correctly. The post-meal spike was delayed significantly and very much reduced in strength. I was actually connected to a CGMS when I started so I got to watch the results in real time, which was really cool.

[Cyborg]

Reply with your question and I will copy it to my list!

:evil: Muh ah ha ha ha ha ha

Got one more:

How long after a meal eaten with Symlin is it ok to do a normal correction bolus? Is the 2 hour mark ok?

Thanks again... Have fun tomorrow!

[lelggren]

Got one more:

How long after a meal eaten with Symlin is it ok to do a normal correction bolus? Is the 2 hour mark ok?

Thanks again... Have fun tomorrow!
I've just been doing them whenever I test and the pump says it is ok to do one. Like, when there is not enough IOB to cover the bg that I'm at. I didn't take into consideration as to how long after! Good thinking! Hmmm......