Symlin/amylin

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drLaurie Posted: Thu, Sep 24 2009 7:50 PM

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I've been using Symlin since Spring 2009 and - except for having to take a shot (I use the pen) before each major meal - I do love the results overall.  For those not familiar, Symlin is another hormone that diabetics are found to be missing.  It normally works in concert with insulin, and it slooows the dumping of digested carbos into the bloodstream.  This slowed dump also lowers the SPIKE that many of us get after a meal.

We take the Symlin just before a meal (seconds before is AOK), eat the meal and compute carbos.  Just after the meal I take a combination bolus with 30% "now" and 70% spread over 2 hours.  Each of these variables is individual, so YMMV. 

Symlin dose does not vary once you ramp up to a "full" dose.  Then, as long as the meal has 30+ carbs or 250+ calories, you can take a dose.

I still struggle with some high fiber meals -- to get the insulin timing & dosing right.  I'd love to exchange tips & tricks with folks also used it.

What's been your experience?

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Julie_ replied on Fri, Sep 25 2009 1:02 PM

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I've been taking Symlin for several years.  I like it because it decreases my appetite, lessens my daily dose of insulin, and does not cause my blood sugar to spike after meals. 

My last 2 A1cs were very high, and my doctor, who is a very astute guy, suggested it was because of after-meal spikes.  I said no when he said it in his office, but after thinking it over, I realized that I had gotten into the habit of only giving about 1/3 of my insulin before meals, and the rest extended over 2 hours.  In addition, I was lax about testing after meals, so I am sure now that the doc was right in his assessment.  I was letting my fears of going low cause me to manage my sugars so they were too high.

After that appointment in July, I started using a 60% before meals and 40% extended over 1.5 hours.  When I test after meals, I am doing OK.  Sometimes I go low in the morning or after exercising.  I think I just need to cut back even further on my insulin when exercising.

I take 90 mcg with each meal.  After a while, the 60mcg was still making me feel hungry after meals, so my doctor let me increase the dose.  The manufacturer (no surprise) told him that was fine to do and many people do it, although most of them are large people, and I am not large.

Julia

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Labby replied on Fri, Oct 2 2009 5:19 PM

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Hi,

I've been using Symlin for a couple of years now.  Prior to taking Symlin, my post prandal readings usually were low 200's no matter what I did.  Low-Carb doesn't work for me, it only allowed me to reduce my insulin but I still ended up with highs after.  I've never been able to figure this out... seems the more insulin I take at times the higher I go. If I eat it's like it soaks up the extra insulin and I start to drop.  If I take too much insulin when I'm eating then I'll go low as well.  I guess I'm kind of weird. :)

At first it made me pretty nauseous but over time that went away.  I use only 2-3u per meal otherwise I drop like a lead brick.  I've had quite a few nasty lows while taking Symlin.  I was able to drop my A1C from mid-8's to low-6's without changing my diet.  Though, I've found if I take it prior to eating, I usually can't finish my meal because mid way through my meal I no longer am hungry and simply cannot take another bite.  I've not lost weight, I don't need to lose weight really.  

I usually do a combo bolus as well when I use Symlin.  I do 55/45 most times which works for me.  I've never taken more than 5u of Symlin.  I seem to be just as sensitive to Symlin as I am to Insulin.  My Basal is set to 18.14u/daily and my TDD usually runs around 28-35u.

Glad it works for you.