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Cyborg

Symlin

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koblenz

Thanks for the update... that's interesting. I have not heard about resistance thing.

 

I am not back to 100% of my pre-symlin dose, but I am up to about 70% or so. I was at about 50%.

 

Well, I guess I will wait for the next big change. Still, weird how it seemed to have happened "all of a sudden"... over the course of just a few days.

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Jorj Gaidin

It's certainly weird. I don't know if has to do with activity level or getting sick... but I'm sure I'll find out.

 

I do find it strange that people require different amounts of insulin when on symlin... some people require only 50% but some like myself started at 80%. I don't know that it's sensitivity because we all show delayed peaks to BG... I can't conceivably come up with a logical mechanism for having different insulin requirements! Any thoughts?

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Guest Ashke
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Hi everyone I am new to this forum.:hello:

 

First off, I wonder if anyone have tried using herbal tea to act as a catalyse to assist your body in accepting insulin and yet prevent side effects from medication?

 

I am from Singapore and am working in Anti Diabetic Organic Herbal Tea Pte Ltd. Although I am only an accountant, I felt that I should help diabetics patients all over the world, rather than only in Singapore.

 

If you are womdering why an accountant should care about the tea and patients, here's my story.

 

No, I am not a diabetic and I dont mean to intrude upon your forum. However, I have an aunt who is diagnosed as one 10 years ago. Confined to a wheelchair a year after medication, all of us are shocked to see how old and frailed she seemed to have become.

10 years ago I was only 12 years old. I asked my mum why her sister looks so much older than her? If medications makes her so, than why should she continue with that? If she stop the medication she will become worse? In that case, is there no compromise? Take medication and yet live a normal life? Just like a normal fever panadol recovery. Mum told me that diabetes is a long term disease and can hardly be cured.

 

However, it seemed that I have found the solution to 'compromise'. Yes, you have to take your medication, but you can lead a lifestyle free of the fear of side effects. And more, over time, you can reduce your medication (your doctor should measure the right amount of medication for your intake when you go for check ups). That's what happened to my aunt, her doctor was very surprised at the rate she's recovering and cut down a substantial amount of medication. Aunt said she's happy enough now that she can walk again, she doesnt care about anything else. haha.

 

Please take a look at our humble website (as Herbalsys/Bao Li Cha is hand-packed, production volume isn't high, that's why my bosses see no need to upgrade the site as demand for Herbalsys locally and in Taiwan can hardly be met, supply is just too low.) Besides, being of an older generation, they do not know how to introduce Herbalsys via web technology, no matter how earnestly they want to help others. (That's why I decided to help them in my small little ways)

 

Lastly, as Herbalsys is made in Singapore (we have a very strict system here for health product), you dont have to worry about the quality. The HSA approved certificate is posted on our website as well.

 

As diabetes can be hereditary, prevention is better than cure. You can eat what you always like to eat, but just remember to drink Herbalsys to remove the excess elements in your body.

 

I supposed I have said too much, there are many things more I wanted to say but I cant put them into words. I guess I will end here, if you want to contact me, feel free to do so

 

Email: herbalsyshub@hotmail.com

MSN: ashkedariel@hotmail.com

 

 

Yours sincerely,

Ashke

Anti Diabetic Organic Herbal Tea Pte Ltd

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Cyborg

I've increased my Symlin dosage to 17.5 units, heading toward 20... So far it has proven effective. It seems to have a longer duration for me with an increased dosage. I'm still investigating with higher carb meals to see if I've resolved the spike in bg that I used to get a couple hours after eating with Symlin.

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Jorj Gaidin

how much of a spike, Cyborg, do you tolerate? Also, what kind of bolus duration are you using with the symlin? I've found that sometimes even an extended bolus gives me too much insulin early and I need to take less symlin to prevent going low. However, this means my spike is at about 160 or so 2h after a meal. This is still much better than 250, but probably not as good as it could be.

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Cyborg
how much of a spike, Cyborg, do you tolerate? Also, what kind of bolus duration are you using with the symlin? I've found that sometimes even an extended bolus gives me too much insulin early and I need to take less symlin to prevent going low. However, this means my spike is at about 160 or so 2h after a meal. This is still much better than 250, but probably not as good as it could be.

 

I think a spike of less than 180 is acceptable, although I'd like to keep them to under 140... The largest spikes are seen when eating sandwiches, cereal, and other higher carb, high glycemic index foods. The spikes I was seeing came after the 2 hour mark, usually between the 2nd and 3rd hour.

 

I've actually done 2 things, I've increased my Symlin dose to 20 units (as of today) and I've started taking my insulin at the same time (15 minutes before eating) unless I'm borderline low.

 

For the extended boluses, I started out using a 40/60 combo over 2 hours, but recently changed it to a 30/70 combo over 1 1/2 hours. I seem to be having better results with this way.

 

For example, today I had a 6 inch sub for lunch with approximately 46g carbs. I didn't bolus for the protein, but with the Symlin I was only 138 about 2 1/2 hours after eating. Without the Symlin I surely would have been in the mid 200's.

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Jorj Gaidin

One of the things I was noticing when taking a combo bolus was that I would go low within 1 hr after bolus. Do you eat something before taking symlin or do you just not experience this? The variability in how people respond to symlin really confuses me. You'd think it would be a little more consistant wouldn't you?

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Belinda

OK I am back on the stuff....I took myself off but then my A1c went up by .7 so now I am back on it.....but only at 5 units will work myself up to 10 again...if my numbers don't drop by September then I will know it is not the meds but something else I am doing wrong...it might be that the pump comes unattached constantly while at the pool....:eek: :eek: :help::banghead:

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Cyborg
One of the things I was noticing when taking a combo bolus was that I would go low within 1 hr after bolus. Do you eat something before taking symlin or do you just not experience this? The variability in how people respond to symlin really confuses me. You'd think it would be a little more consistent wouldn't you?

 

I wore the Dexcom CGMS while on Symlin so I got to see the results of the Symlin in near real time. The results were amazing. I had a plate of spaghetti and sauce, approximately 80 carbs. My bg started at around 90, dipped slightly and stayed below 90 for nearly 2 hours, then rose up to approx 140 for about a 1/2 hour before returning to target.

 

Symlin definitely has the potential of sending you low, so I think it's very important to increase dosage slowly. Tweaking the combo bolus duration and percentage can take time, but is worth it. I lowered my initial percentage of the combo bolus to avoid going too low during the initial 2 hours and to assist with the spike I was seeing at around 2-3 hours.

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Belinda

OH a perfect idea to wear a CGMS with it....I am going to ask the endo to do this in the fall....can swim with the cgms so summer is never a time to wear it again...

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Cyborg

I've started taking my Symlin 3 times a day pretty much (20 units). I seem to be having a low here or there and was wondering if anyone has experienced lower Symlin requirements over time?

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Cyborg

Well, tonight I had a 77g carb dinner. My bg was 110 before taking my Symlin and insulin. I started eating within about 5-10 minutes max. At a little less than 2 hours I had a 58 bg. I corrected with a four glucose tabs to bring me back up to 138. The 2 hour post-meal bg spike associated with the Symlin should be starting, so hopefully the insulin on board, in my system, will be enough to handle it and the 138. I'll be checking often for the next hour or so.

 

I've been experimenting with Symlin and various combo boluses. Tonight was a 2 hour bolus with 25% of the insulin up front. I had a high 77g carb dinner of Marie Calendars Spaghetti (accurate carb count from the frozen dinner). I took 75% of my regular bolus and this time I started eating before 15 minutes since I was close to my target bg before starting. I even included my correction bolus before calculating the 75% insulin value.

 

I think next I will try a 20/80 bolus over 2.5 hours and use only 66% of my normal non-Symlin insulin dosage.

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Belinda
Well, tonight I had a 77g carb dinner. My bg was 110 before taking my Symlin and insulin. I started eating within about 5-10 minutes max. At a little less than 2 hours I had a 58 bg. I corrected with a four glucose tabs to bring me back up to 138. The 2 hour post-meal bg spike associated with the Symlin should be starting, so hopefully the insulin on board, in my system, will be enough to handle it and the 138. I'll be checking often for the next hour or so.

 

I've been experimenting with Symlin and various combo boluses. Tonight was a 2 hour bolus with 25% of the insulin up front. I had a high 77g carb dinner of Marie Calendars Spaghetti (accurate carb count from the frozen dinner). I took 75% of my regular bolus and this time I started eating before 15 minutes since I was close to my target bg before starting. I even included my correction bolus before calculating the 75% insulin value.

 

I think next I will try a 20/80 bolus over 2.5 hours and use only 66% of my normal non-Symlin insulin dosage.

 

 

 

For me it takes pasta a while to break down...when I did my bolus up front I went low within the hour....try 50% of it and the other over a longer period of time....20 units of symlin is a bit much but if it works for you.....:smile:

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Roberta

Hi Jorj,

Symlin is covered by my insurance,however there is no generic and it is not a preferred medication so I pay double what I pay for 2 bottles of insulin for one bottle of Symlin.

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Dresdentut

Although I haven't started taking it yet, I found Symlin on the list of covered prescription medications for my insurance carrier, Aetna. I must add, however, that it is at the highest co-pay level. For me, that's $40; the cost of a bottle without insurance is about $110, according to Rite-Aid and Costco.

Regards,

Jeff

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MamaCat

I'm a Type 1 pumper who just started Symlin three days ago, although it's actually my second go at it. Today I had my first success (due in large part to the comments I've read on this and another blog). May I share?...

 

This morning I had a high fasting bG (191!), bolused to correct (without success) so changed out my cannula and fasted, except for coffee/iced tea, until my bGs came down to a reasonable level. :whistling At 2:00 pm (FINALLY!) I was down to 148 and thought to myself, "time to strap on the feedbag." So at 2:15 pm I had lunch ready (calculated at 30gms. carb.), took my Symlin, and began eating immediately. I continued my regular basal rate but did not bolus. I had that uneasy feeling of my bG dropping while I ate, and sure enough, 30 min. after eating I was down from 148 to 107! Would I go lower? Would I crash? I continued to feel "edgy," but at 60 min. after eating my bG was 111. Okay...it had been an hour so I figured I might be out of the "crash zone." That's when I had planned to take my meal bolus, hoping to prevent the 2-3 hr. spike I always had experienced before. (btw, I set my alarm clock on the pump to remind me to bolus 1 hr. after eating.) Neither the 50% usual bolus recommended nor 60% has worked for me (not as one dose, dual-waved, or squared). So I bolused at 70% my usual dose and square-waved it over 2 hours (the "spike zone"). Well...bG at 2 hours post meal was 134, and bg 3 hours post meal (and at the end of the bolus) was 123. :biggrin: WOW! Do I feel good! I'm still not hungry so I plan to have a later dinner, which probably will be a low-or-no carb salad (small).

 

Any suggestions from those of you experienced at this? Am I on the right track...FINALLY..?!

(Atta-girls kindly accepted... :party:)

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Cyborg

Seems like you are doing great. Figuring out Symlin can be tricky. Other pumpers on this forum helped me out also. Keep sharing new Symlin tips. I have tried taking my Symlin many different ways, even with zero carb meals...

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MamaCat

Cyborg, what kind of effect have you gotten with a carb-free meal? Have you tried Symlin without a meal? And what Symlin dose are you using now?

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Cyborg

For high protein meals or protein only meals, I calculate the equivalent carbs for the protein (2/3 to 3/4 of protein content), then take 75% of that value as I do all insulin boluses while using Symlin. Without Symlin, I would bolus for protein using a 30/70 combo bolus over 3 hours. I know the Symlin will slow digestion so I will change that while taking Symlin to something like a 15/85 split over 4 hours.

 

For example, if I ate 40 gram of protein w/o carbs, I would calculate that as 30 gram of equivalent carbs. Then to bolus I would take 75% of that value since I'm using Symlin. Thus, I would bolus for 22.5 gram of Symlin adjusted equivalent carbs. I would do this bolus as an extended bolus 15/85 over 4 hours. Of course your split and bolus duration will probably vary and I am still experimenting with mine. So far, I've had good results.

 

I've seen the effects of Symlin alone while waiting the recommended 15 minutes before eating. It can induce a low taken without food, even without insulin. In fact, whenever I am close to my target bg, I adjust my combo bolus to give less up front. If below target, I will either pop a few glucose tabs or skip the Symlin altogether.

 

I'm currently dosing at 17 1/2 units of Symlin. I did get permission from my endo to go up to 20 units. I do feel a little more nausea than I'd like at 20 units and that's why I moved it down.

 

Good luck and let us know how it goes... :)

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MamaCat

I've never bolused for protein meals since I've never seen them make an obvious change in my bGs, but obviously any meal with sufficient calories warrants Symlin according to their own guidelines (30 gms carb OR 250 calories). I had suspected the Symlin would have some action even without a meal, simply because of the basal insulin...

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MamaCat

Symlin seems to be working well for me, since I came up with a "formula." Based on others' experience (not the advice of my endo, but I'll deal with that later) I have titrated up to 20 units (I'm Type 1). Like the lower doses, I had some abdominal discomfort for 2-3 doses then was fine. The higher dose does seem to have a direct effect on reducing those postprandial spikes. At 20 units, my two-hour post meal bGs are averaging 140. At 18 units, the two-hour test was 160 avg. (at lower doses it was even higher). At one point, I titrated back down from 20 units (I was having second thoughts about what my endo was going to say). Sure enough, my postprandial bGs went back up. So, I'm sticking with 20 units for now.

 

I check my bG so I know my starting point, then take the Symlin just as I sit down to eat. I make no changes to the basal rate on my pump. I set two pump alarms for 1 & 2 hours later. At my 1-hour alarm I check my bG and bolus for the total carbs eaten (70% my usual bolus, square-waving it over 2 hours). I set the bG reminder for 2 hours. At the 2-hour alarm (2 hours after the meal/Symlin and 1 hour after bolus), I check my bG again. At the pump's bG reminder (3 hours after the meal/Symlin and 2 hours after the bolus), I check my bG once more.

 

I look forward to doing my endo's 3-day CGM on this, but with the hourly testing I'm getting a good picture of Symlin's action. With the regimen of eating at the time of the Symlin dose and waiting one hour to bolus, my bGs don't bottom out but remain fairly level. My bGs will rise over the next two hours, but bolusing at 70% over those two hours (with a full 20 units of Symlin) is keeping the rise to a reasonable level.

 

As for exercise, I wait until at least one hour after eating when I've dosed with Symlin.

 

I see my endo. in a month and can't wait to see my A1C!

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jeggeman31

Figured I would bring this thread back up to the top of the list to see how you guys are doing. I just started Wednesday and am doing 20 units twice a day. I have found my BS are doing better. I also found that if I eat pasta, I can't bolus for it at the beginning or my BS will crash. It is strange eating less food.

 

 

Weight loss issue, for anyone that would like to share, what has your weight loss been?

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Cyborg

I'm still taking it, but not as often as I probably should. When I go out for lunch, I don't have it with me. Sometimes I eat very low carb meals and do an extended bolus for the protein, the Symlin is not really needed. There have been times where I'm not feeling well, and I won't take the Symlin because I don't want the nauseua. And then there are the times where I don't want to wait 15 minutes or perhaps my bg is too low.

 

I don't take Symlin for weight loss. I do see how the nauseua and/or the feeling of fullness you get on Symlin could contribute to weight loss.

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