Question(s) about Symlin

Treatment Oral Medications and non-insulin injectables
1

I was wondering if it would indeed help me any.

My 1st phase insulin release is nearly non existent. But 2nd phase seems OK most of the time.

Currently, I am using Humalog Kwikpen. Sometimes I take 10 units, other times I need 30 units (sheesh).

I split the dose as much as I can. Like 5units at one site, 5 another, but at the same time for the same meal. Faster absorption that way.

Does Symlin increase the effectiveness of insulin?

What are the pro’s and cons, short version please?

Typical dosages, times, carb coverages, effectiveness with exercise, etc would be great!

I see my endo here in about 7 weeks. My last A1C was 5.1, but due to illness, injury, and bad weather, my next one should be nearer to 6.0 - sigh…

I tried Victoza - that was a disaster. No help for the 2 hr PP, and it made me go LOW after that.

Thanks for any help, experiences, and any insight.

PS sometimes I need my ISF to be 1:5, other times, 1:15. My lifestyle is far too random to predict any anticipated insulin usage.

Most of the time, I have a good guess.

2

Also, how does this affect your appetite?
Any unusual food restrictions or interactions you have experienced?

3

I have been on Symlin for about a month and a half now and I am loving it. I also tried Victoza and it did not do to much for me, it was ok for the first 3 weeks but then I could no longer see a change. Yes the symlin dose increase you insulin effectiveness and you should be able to cut your reg insulin dose back I have by about 8 units every meal time!

Although I was on Symlin over a year ago and I really dont remember it working this good but we do have to remember that or body’s change so something might work that for you that didnt in the past. I would say go for it give it a try!

4

For me there is not much diff in my appetite but I am only on the 30 does of it so that is prob why I don’t really see a big change with that. No probs with any foods for me and i also had no side effects from it like the nausea, but I started out at the 15 does for about 4 days then went up to 30.

5

What made the doctor decide to give you Symlin? I would like to try it since my insulin dosage went from 10 units to 25-30 units per meal. Did you have to ask for it? Did they have to do any blood work to see?

I pretty much eat the same amount and types of foods every day.

But no low carb diet. Just a real diet. Like a bowl of cereal with a banana in the mornings, lunch varies (usually fast food - the eat it while driving type foods), and dinner is guess your best. It all depends on what I am doing and where I am at. I have a completely random lifestyle so eating at exact times and exact meal types is impossible. Except for breakfast most of the time.

At times, I have to take 3 kinds of insulin - Humalog (5UI + 5UI), Humulin R (10UI) + NPH (5-10UI). Gotta love taking that in 4 shots at one time just to get it to absorb fast enough and try to keep blood sugars under some sort of control.

I was debating on if I should call my endo and ask for it to be called in or just wait another 6 weeks to see her then ask.

6

Just a couple suggestions: You might ask your doctor to put you on a more current insulin regimen: a long-acting basal insulin and a short-acting mealtime bolus. Since you said you can’t eat at exact times and foods, the older insulins you are taking (regular and nph) make it much more irregular. Also, there’s a big range between “low carb” and the typical diet non-diabetics eat. If I ate a bowl of cereal and a banana my blood sugar would be about 250! If you reduce your carbs a bit you wouldn’t have to take as much insulin.

Personally, I would try those things first before adding another medication.

7

The problem with reducing carbs is that I won’t be able to eat enough calories in a day. Protein costs too much - sigh.

I am hoping to just use Symlin and Humalog at mealtime. Dosing is very difficult lately. Don’t understand why except maybe because of high financial stress…

PS a bowl of cereal and a banana will spike me into the 250+ range without insulin.

I want to do more exercise, but between the bad weather and Achilles’s tendonitis, exercise is not something I can easily do. Sot-ups? Nope. Bad back.

About the only exercise I can reasonably do when no tendonitis is walking.

8

I am falling into major depression again. The fatter I get the more depressed I get…

9

Sorry to hear that, Zolar. Diabetes can be stressful and financial problems definitely add to that! Since it seems like you do have some insurance, perhaps you can see a counselor, preferably one who is at least familiar with diabetes. Also, do talk to your endo about changing your insulin regimen. It is making your dosing more difficult and probably adding to your weight gain. Also a good nutritionist can help you learn to eat more healthy while on a budget. What you eat definitely affects your mood as well as your weight!

10

Thanks for the suggestions.

I am not on any insulin regime. I guess mostly as the sliding scale the doc wanted me to do didn’t work. My system usually does, when the weather is good.

A nutritionist can’t help me. Saw one already. If you eliminate carbs and veggies what else is left to eat?
I never have nor will ever eat veggies with a few exceptions like potatoes and corn.

I am stuck…

11

Zolar, I need to say that you definitely sound depressed and imho that is keeping you stuck. In order to make changes you have to be motivated and open to trying new options. Depression works to keep people unmotivated, hopeless and yes…stuck. I encourage you to get help for the Depression and then the rest of it will follow.

12

I know this is hard to hear - but the more insulin you take, the fatter you will get. Insulin, for insulin resistant types (like me), just packs the pounds on.



I’m sorry, but reducing carbs does NOT mean you won’t be able to eat enough calories in a day. Low-er carb doesn’t mean no carb. Protein costs too much? So, how much would you say the carbs are costing you in terms of quality of life? It’s a matter of WHICH carbs and HOW MANY carbs. A bowl of cereal…which cereal? Any actual nutritional value to that cereal or just empty white carbs? Ever thought about a high fiber cereal like multi-grain Chex or even better, shredded wheat? Milk - regular or 2% milk? Ever thought about Hood milk - it’s low carb and tastes great? Banana - the hugest banana you can find or just a medium banana? Ever thought about berries in your cereal (they are low-er carb). I’m not surprised you are spiking. Here’s the reality - the truth - you cannot eat as if you were not a diabetic - especially if, as I suspect, you are insulin resistant. You just can’t - not and be healthy.



Your answers lie in educating yourself and learning to be accepting and taking responsibility for your health. If you can do that, you will be amazed at the progress you can make. Being unhealthy, to me, is the worst kind of depression.



If walking is the only exercise you can do - then do lots and lots of it. Can help the depression, too.



Take care

13

Well, when I went nearly carb free, I kept losing weight at a rate of nearly 5 pounds of body weight a night.

Once I went on insulin, that problem reversed due to my ability to eat more carbs.

Quality of life issues: I should be able to enjoy a piece of my 8 year old’s birthday cake with some ice cream after dinner. And enjoy thanksgiving dinner with all the trimmings except the obvious cakes & pies.
To be able to go to a restaurant and be included into meal (aka help eat pizza for example) instead of being an outcast food wise.

I tried all the gimmicky foods and drinks - egg beaters makes me VOMIT.

I have always had a very narrow diet that I cannot ever deviate from. Adjust the amounts, but never add any new foods.

Berries - ALL berries spike me 50 points for some reason.

You ask for a complicated explanation of why I eat the way I do. It stems from severe abuse issues when growing up. Something that will never allow me to eat the disposal type diets that most people eat today.

Banana - yes, a medium one.

Protein - I need to eat greasy hamburger and fatty sausage for blood sugar control. But those cost too much to eat constantly. Chicken & fish are worthless. Those don’t hold back any spikes at all for me.

About eating as a non diabetic - yes I can. I know how to do it and keep blood sugars under tight control. But the price is too high. I cannot life that lifestyle - eat, then bust my butt to burn off the blood sugars, then eat, then etc, over and over, day in day out. I already sis it. I could eat candy, sugar, cereal, anything I wanted. But I had to work it off immediately and for MANY hours at a time. I got my A1C from 6.8 down to 5.3 like that.

Can’t walk right now. It has rained nearly every day for the past 6+ weeks.
I will only walk in fair weather, and without going anywhere that I can’t walk to from my home and back.
Gas costs too much too.

If I were a multi millionaire, I could follow a terrific lifestyle. My own Gym in my home, bicycling in a decent neighborhood, eating the quality protein I need to, etc.

But I am poor and cannot afford anything like that.

So, I have resigned myself to dieing from complications because I am financially handicapped.

About education - my own doctor told me that I could be a ‘diabetic guru’. I asked questions that they couldn’t answer, but I could.

I learn constantly. But the same information get boring. No new info out there.
But thanks for the thoughts and suggestions.

PS I do not count carbs or exchanges. Too difficult, too time consuming, and a pain in the a$$ to even contemplate. Pretty much I need between 10 and 20 units of insulin per meal. 30 if I eat something bad like a piece of pie for dessert.

14

I find this all very, very sad. For me, a quality life is a healthy life.
Learning and applying are two different things.
I wish you health and happiness.

15

Thanks!

To me, quality of life does not mean to be a slave to any disease. If you live for a disease, that’s all you live for to the exclusion of everything else.

Who wants to worry about every little thing you eat and be paranoid about future complications later on in life?

I do not mind treating my diabetes within reason, but I am darned sure I will eat a piece of my 8 year old’s birthday cake when he turns 9, and not give a care about blood sugars that night.

Do you have any idea just how hard it is on him for me to tell him that I can’t have this or that?

He does understand a little, but that doesn’t make him feel any better when I have to sit on the sidelines (food wise) and not be a part of my own family.

I take insulin so I can have some semblance of a normal life…

16

Oh, and very expensive car repairs are like having a money attracting black hole in my life…

I didn’t shoot any insulin this morning. Ate one White Castle’s breakfast sandwich. My 2 hr PP was 130. Fasting was 98.
But the reason for this is that I went shopping to get my wife a birthday present, something to feed my sick son, and the entailed some walking.

I just am not apparently allowed to ‘eat and sit’ if I want reasonable blood sugars (sigh).

17

Tomorrow is my wife’s birthday. I will eat a piece of that $20 birthday cake I paid for and a scoop of ice cream.

Problem is that I will only be able to eat it around 9 or 10pm at night due to a school play my son is in. Then about an hour later, go to bed. Gotta just love the resulting spike - probably into the upper 200’s while sleeping.

A friend gave me some Lantus. I rarely use it, but that night I guess I will need some.

I don’t like Lantus because it causes me very rapid weight gain. It seems Levemir does too, but not quite as fast. Had a sample back in January.

I hope Symlin will be the trick to controlling blood sugars and NOT getting fat in the process.

Victoza really doesn’t help much.

I won’t take pills. Got enough problems without having to remember to take one at a regular interval throughout the day and be forced to eat precise meals as well.

Insulin works very well, provided I give it a little help like walking.

Anyone take Lantus, Insulin, AND Symlin each day??

Results?

My goal is to have my A1c under 5, preferably under 4.8 (my wife’s A1C number and she is not diabetic, but 125 pounds overweight)

I can do it with or without a doctor, but prefer to do it the right way. The data they can glean may be of some use statistically to others.

But, I can make regular insulin and NPH work. Just takes more effort and timing to do it, but I can do it if need be.