simlin problems

bill c · #1 (**permalink**) 04-27-2006, 03:16 PM

hello all
i started simlin a couple weeks ago and my bg levels are going out of control.
im now on my maintence dose of 10u before each meal and i cut my novo dose in half like my endo said to do. i test six times a day and ive been between 200 to 300 almost every time for the last 4 days. my bg seems to drop to 150 to 160 about 2hrs after meals but then goes back up to 200 to 300 by the next time i have to eat so im always making corrections on my novo dose.my last a1c before simlin was 7.1. can anyone advise? i dont see my endo for two weeks.....

JediSkipdogg · #2 (**permalink**) 04-27-2006, 03:19 PM

What other insulin do you take and how often do you take that? When you say Novo do you mean Novolog or Novorapid? They are the same pretty much, but just help me get a better understanding of what you take. Tell us a little more about your numbers 2 hours after meals BEFORE symlin.

bill c · #3 (**permalink**) 04-27-2006, 03:46 PM

im also on lantus , 1 nite time injection. and novolog. before simlin my bg 2hrs after meals was usually +20 but would level out by my next meal. generally good control. it seems like im taking more novolog now trying to correct my high bg readings than i was before i started simlin. i really want this to work but am getting verry frustrated and concerned....

JediSkipdogg · #4 (**permalink**) 04-27-2006, 04:03 PM

When you started Symlin did you cut your lantus injection back at all? Also, maybe reducing your Novolog by 50% was too much. Maybe trying like 75% would be a better start.

lelggren · #5 (**permalink**) 04-27-2006, 04:07 PM

Quote:

Originally Posted by bill c

im also on lantus , 1 nite time injection. and novolog. before simlin my bg 2hrs after meals was usually +20 but would level out by my next meal. generally good control. it seems like im taking more novolog now trying to correct my high bg readings than i was before i started simlin. i really want this to work but am getting verry frustrated and concerned....

I think you should call your dr. I just started on symlin a few days ago, and my dr said that there would be some bg fluxuation while we get my insulin doses figured out in accordance with how the symlin acts with my system. Maybe your doses just need to be tweaked? Certainly don't wait the 2 weeks in misery until you have your appt. I have noticed in the last few days that I have had to do a lot more correcting, but it is in smaller doses. So, while it may feel like i'm taking more insulin, I'm really taking around 20 units less in a day than I was before.

kidvid · #6 (**permalink**) 04-28-2006, 05:28 AM

I don't know if your circumstances are like mine, but when I was on Symlin I cut my bolus in half (Humalog) for the first few weeks, but I had to inch it back up to exactly what it was before starting Symlin (1:10) eventually. It was very successful in eliminating post meal spikes for me. I used it until I went on a pump.

Joe

Cyborg · #7 (**permalink**) 04-28-2006, 05:42 AM

I'm also on Symlin and I've noticed that I have to do an extended bolus (I'm a pumper) when I take it. I've heard recommendations from other posters on MDI to split their bolus up. What may be happening is that the delay in digestion is affecting your bg levels and you are actually under dosing your boluses. If you take more insulin for your bolus and split it, say take 1/2 when you eat and 1/2 approx 2 hours later, you may find the results you are looking for. I watched the effects of Symlin on a CGMS and it absolutely delays the digestion and subsequent spike in blood glucose.

bill c · #8 (**permalink**) 04-28-2006, 01:52 PM

thankyou for all the replies.
my endo finally called be back today and said to take my full dose of novolog(1/10) before meals along with my maintence dose of simlin 10u until i see my bg's start to come down and then ajust as needed. all my readings have been good today, high of 101 low of 72. but i only did 75% of my full novo dose, i guess i was scared of going 100% while at work. now i feel a little better because im trying to heal from weekly laser treatments. thanks again, talk to you all soon......

Cyborg · #9 (**permalink**) 04-28-2006, 03:02 PM

Quote:

Originally Posted by bill c

thankyou for all the replies.
my endo finally called be back today and said to take my full dose of novolog(1/10) before meals along with my maintence dose of simlin 10u until i see my bg's start to come down and then ajust as needed. all my readings have been good today, high of 101 low of 72. but i only did 75% of my full novo dose, i guess i was scared of going 100% while at work. now i feel a little better because im trying to heal from weekly laser treatments. thanks again, talk to you all soon......

Based on my experience and watching my bg on the CGMS after taking Symlin, I would recommend against taking a full dose of insulin with the Symlin. The people that make the medication also say the same. They have a customer support line: 800-349-8919.

If you boost your insulin % anymore, make sure to test at least every hour for the first 2 hours, you will be putting yourself at extreme risk for a hypo. I've watched my bg flat line for nearly 2 hours after eating a 76g carb dinner of spaghetti after taking Symlin and 60% of my regular insulin bolus, and the bolus was an extended bolus done through my pump.