How many times a day do you take Symlin?

I am taking Symlin now for 3 months. I have been taking the 60 because I am a T1. No nausea.

I am only taking it at breakfast because that was the only time I am spiking during the day.

So, how many times per day are the other Symlin users taking an injection?

I’m just starting out with this stuff and finding it pretty scarey . . .Dexcom monitor says I’m going down when bs is 45 or lower. Tomorrow I’m going to just try it at breakfast and work with using a delayed delivery of my insulin. I haven’t had any nausea either.

I am T2 and I take 60 at each meal. I have had no nausea or other side effects and have lost about 27 pounds as a result of never being hungry,

Wow. That’s a big achievement. How long did it take to drop the 27 pounds.

About three months. But now I’m at a standstill so am planning on starting Dr. B tomorrow.

I have type 1 diabetes and have been taking the Symlin for 3 years. I am taking 90 mcg (15 units) before each meal. Never had any nausea and just kept tritating it until it worked the best for me. I have also used very small amounts to keep my liver from dumping when I am not eating or after intense exercise. It has really helped smooth out the spikes for me.

Well, I guess there isn’t a set rule of 60 mcg for a type 1. Are you using the symlin pen? If so, do you take 2 injections to get the 90? Or, are you using the 120 symlin pen?

I take Symlin three times a day: at breakfast, lunch and dinner. I use the Symlin pen. I have found that it helps my after-meal spikes.

I currently take 30 mcg, three times a day (breakfast, lunch and dinner). I just started a week and a half ago. I am noticing that my sugars do not spike, however I am dropping low and then staying kind of low until I have to treat before my next meal. I even try bolusing an hour after eating and square waving that for an hour, and I still drop.

I just started symlin a week ago and am trying to get all the information I can. I am type 1 since about 35 years and on pump and CGMS. My HbA1c is 6.6 and I can’t believe I can’t get it lower with the CGMS etc. The fact is there are peaks when you open your mouth and eat something. It takes even the fast insulin two hours to work. I use Novolog. I have gotten into the habit of bolusing every time my alert says I am going high (above 140) and that has led to some lows because often it is just time for the IOB to act. I am not overweight but have noticed a few pounds I can’t get off and I am always hungry.
I had to plead with my doctor for a prescription for symlin because he said “I am in good control and not overweight etc”. I promised him I knew what I was doing. Of course I don’t. Anyway I started last Wednesday at the 15 mcg level for dinner. Then added lunch. I have not had any lows but I cut the insulin in half just to be sure. I don’t see the peaks in the 2-3 hours after eating but now it seems to go high about 4 hours later, maybe because of less insulin or slower digestion. I was prepared to feel really nauseated but it is not so bad. I am not hungry, that is for sure. I have also lost 3 pounds in 3 days. That will stop I am sure and I don’t want to lose more than about 6 pounds. I will probably change to 30 mcg tomorrow. Does the effect wear off. Using the pen is not bad but it brings back all those pen shots before I went on the pump (about 2003).

Hi all. I’m going to my doctor today to get put on Symlin. I want it mainly for weight loss. I haven’t gained a lot but I have gained 8-9 pounds which bothers me as I got to my ideal weight after diagnosis (I was 40 overweight) and I want to stay there! I don’t overeat or take a lot of insulin but it does seem I’m on a slow steady rise and I want to nip it in the bud.

How did you all know when you are at your ideal dose? Do you base it solely on your reduction of spikes or did you just automatically titrate up to a certain level? I’m Type 1 and also 62 years old so losing weight isn’t all that easy. I eat under 100 carbs a day and thought I might lower it to 70 to help.

Zoe, you will like the symlin. I have been on it 5 weeks and I really like it. No spikes after eating and I can eat things I avoided before like cereal and milk. I still get a rise in BG 2 hours after eating but I give a bolus then and all is well. At first I was a little nauseous. Start at the lowest dose and stay there a week, then move up. I am at 45 mcg and may no go up to the 60. This seems to be working. I lost 5 pounds so I am back to “normal” weight and my clothes fit well again.
Good luck.

Thanks, Maureen and congrats on your weight loss! Do you mean you wait until two hours after your meal to do your insulin bolus, or do you mean you take it as usual before your meal and then correct if you are high?

What percent did people find they were lowering their insulin? I have been reading 50%. Is that common? Even if you are on a relatively low bolus dose?

I take 50% insulin (or a little more) before the meal. Then I take the rest at two hours after the meal. For me that works now. Another person named Julie has been using symlin about 6-7 years and says she does the insulin as a square wave, I guess for 2 hours. I tried that and it made me go low during the two hour period and also a little afterwards. It takes a while I guess to find what works for you. Overall my insulin is down a bit. I usually take 28-30 units a day and now it is 22-24 units. Be prepared to feel a little sickish at first. It happens but that goes away after a couple of weeks. I started with only my evening meal because that is my largest. I only eat one slice of toast for breakfast and a sandwich for lunch. Now I am doing all three meals. I called the Symlin help line once and the nurse told me some people can get help with only 15 mcg and don’t go higher. I seem to read about people using more even than the 60 mcg. I am at 45 now.

I’m a little confused. Nothing in the Symlin literature says anything about taking your insulin later. What is the reasoning behind that? The only things I understand about Symlin is that it’s a hormone we don’t produce when we don’t produce our own insulin and that it helps insulin to work better, meaning we can take less insulin. Also that it makes us feel full more easily and thus eat less and lose weight. I’m on the pump, so taking a combo bolus wouldn’t be hard, but I usually only do that for high carb/high fat meals like pizza.

I’m also reading in the Symlin literature that we will possibly lower our insulin by 50%. It sounds like yours is not that much of a reduction. I like you don’t take a very high TDD, so maybe that is why our reduction isn’t that high?

The Symlin literature says to take it for meals of 30 carbs or more. My weekday breakfast is less than that, and my lunch sometimes is as well, so I guess I’ll not use it for those meals. To the OP question, I am not necessarily taking it for problems with spikes (though more stability and a reduced A1C is always nice!) but to lose a bit of weight and prevent more gain.

You are right. They don’t say take more insulin later but several postings I read said that the BG goes up after a couple of hours (when your food does digest). The symlin slows the digestion and prevents the production of glucagon so there is no spike.When the literature says take 50% they mean with the meal to start so you won’t go low. That is important especially at first until you know how your body works with the symlin. I have a pump too and the CGMS. Without the pump I think I wouldn’t even try symlin. You don’t want to go low because it is harder than normal to bring it up. When you start you can call the symlin help line. They are nice and will answer questions. I am just learning all this because I have only been taking it 5 weeks. I wish there were more lists with people’s comments but there aren’t many. Good luck. maureen

Thanks, Maureen. It sounds like taking Symlin will definitely be a process of trial and error! When you mention the Symlin Help Line do you mean 1-888-Symlin?

Yes, I’m going to start at the 50% less insulin to be safe and if I’m high I will take more. Thanks for your help!