I am going to try Symlin for the first time & I'm not sure what to do-
my Endo said to reduce my insulin dose by 25%-50% depending on the dose... I can't find the paper I wrote what he said on: it was either 25% insulin reduction for 45mcg & 50% reduction for 60mcg or the other way around. The Symlin dose is 45mc on the rx directions, however, the packaging says to start with 15mcg and to eat directly after injecting it.
I'm low carb at around 50g per day- my last A1c was 5.1. I usually eat around 25g for dinner nad 8-14g for other meals... my calorie intake is prolly 250 or more for each meal so I think it satisfies that requirement.
For the dinner meal I take anywhere from 5-8 units novolog and I always wait 20 minutes now to eat.
So what do I do? Do I inject my insulin, wait 20 minutes and then inject Symlin and eat directly? I have no idea how to time this and I don't want to go too low.
I'm still insulin sensitive overall, but I have gained back my lost weight and I usually need a lot more novolog for meals & corrections now than before, although I still go low sometimes afterwards...
I'm trying Symlin to help with my hunger feelings from being on insulin.
Am not sure how to help, but as I know, you should not take Symlin if you are eating carbs below 35g?
Not sure either why your Endo put you on it, since your A1C is good. My A1C has always been around 8, am taking Symlin and hoping to reach a low number!
When I started using it, first I did 15mc for 3 days, then 45mc for another 2-3 days and then 60mc forever. Symlin have a nice support for patient, I advise you to visit their site and even contact them for help! You can always call your Endo to.
I asked him to rx it because I feel hungry a lot of the time on insulin and symlin can help this because it slows digestion... I'm also taking a lot more insulin for meals and corrections now even though I'm low carb so hopefully this can reduce my insulin dose...
Also, the requirement is 35 g of carbs or 250 calories- my meals are all over 250 calories even the lower carb ones I think due to higher fat and protein content..
I am going to call them tomorrow and call the Symlin help too before trying it. I just saw my endo and I forgot to ask about the timing because I didn't realize it would be an issue.
How are you dosing 45mcg? my pen gives either 60mcg or 120mcg. I did not adjust my insulin/carb ratio or my basal rate. I adjusted my bolus according the the reduced portion and carb total I consumed. I have lost 12% body weight in the first two months and have a much reduced appetite. At first there is a little nausia after meals but found that it is goes away after a few weeks and usually is when i over eat. I has been a great addition to my Diabetes weapons.
hi gawnfishin, my pen goes from 15 mcg to 30mcg to 45 mgc to 60 mcg.. I guess it's a different pen? I had really bad nauseau at 30 mcg to the point I could barely eat and I had to lie down for a few hours.. I have some lack of appetite at 15 mcg. It has been making me go very hypo at times in the middle of the meal so I may reduce insulin dosing more... the problem is the same as with only insulin for me.. if I take a little more, I go hypo, if I take a little less I go up way too much.. there is no right dose for me most of the time apparently.. I haven't lost any weight... I have only been on symlin one week or so... I'm not overweight, but I have been gaining back weight after dka since on lantus and I don't want to gain more... I'm not eating more.. very odd.... I have to call my endo and ask what to do about the nausea. It does seem to lower my feeling of hunger after meals.. however as soon as I have to take insulin to lower bg my hunger comes back. That is the main reason I'm trying symlin.
oh btw, my endo not only told me to reduce insulin by 50% they said to also wait my normal 20 minutes before eating. However 50% reduction was too much as I went up to 130 after a meal. So I'm only reducing by a small amount.. but then I often go hypo.
Honestly, there does not seem to be a set time for people to take symlin and insulin. Some take it right before their meal with their insulin. Some take their insulin an hour after eating. I found varying results both ways. I started taking both insulin and symlin right before eating and it would shoot my sugars extremely high at later times of the day. I began waiting an hour after eating and taking symlin. It somewhat helps but my sugars seem to run high most of the time. These so lows they warn about I have yet to experience. I rarely ever get low. I eat healthy and take proper insulin amounts. However, it seems like my insulin is just water sometimes with symlin.
oh.. I am taking it directly before eating.. I wait 20 minutes after bolus to eat then I take symlin, then I eat... that is what my endo said to do.. I think I am having the same amount of hypos with symilin although maybe a bit more.The lows feel different to me a bit but I'm not sure how to describe it. I do still respond to glucose to bring me up but it may take a tiny bit longer at times. My main reason for symlin is to stop feeling hungry all the time on insulin and it does help with that but only when I take it at the meal time afterwards if I need to do a correction etc. I start feeling hungry again.. I wish there was another appetite suppressant to try. My sugar does go up later on with the symlin too but it often did that anyway. I can ony take 15 mcg of symlin as it makes me feel nauseous, often even at that dose it supresses my appetite so much that I often don't eat enough and may go low in part due to that. At 30 mcg I became very nauseous. I find it very hard to determine the "correct" amount of insulin for each time, it varies every single time even if I eat the same thing. If I take a little more insulin I go low if I take a little less I go high. And many times I go high without food at all with no explanation.. often while I am exercising...it is just one big fat pain in the butt!
Your endo said to take insulin 20 minutes before taking your symlin? Symlin slows down the glucose absorption into your blood stream and I would think that would cause you to go low if you took insulin 20 minutes before symlin and before eating anything. Your insulin is lowering your BG and the food isn't absorbing until later on. Are you sure this is what your endo told you to do? Sounds dangerous to me.
I think I said that wrong... I have been waiting for 20 minutes after bolus to eat because I go up too high otherwise... so my endo said to keep doing that but take symlin immediately before eating. I guess it could be dangerous, but to be honest I have hypos even without symlin too. I am most of the time very insulin sensitive- a small dose change can send me in the wrong direction. I had a larger desert portion last time and this stopped me from going low for two nights now with dinner, but then later on I have to take more novolog to stop from going higher- again I usually have to do that anyway with or without symlin. The benefit of symlin is I can go longer without eating and I don't feel so hungry all of the time. Symlin doesn't seem to slow down my absorbtion of glucose tabs etc. I still respond to them for lows, but the best thing is to eat a little more to avoid the low.. problem is it is very unpredictable for me how much I need to take/eat.
