I started Symlin yesterday and want to say first I’m grateful to all of you who have posted your experiences with dosing because otherwise I wouldn’t have known not to bolus my insulin ahead of time and would have gone quite low, which since I live alone could have been dangerous! I know I will have to find my own system of dosing that works for me, but it was good to have a place to start!
I especially want to thank Jason for his Guide http://www.tudiabetes.org/profiles/blogs/a-practical-symlin-guide-for-1
A couple questions about this forum: Could Jason’s 3 part guide be put up as a sticky? I just came upon it by chance and it’s very useful. Also, is there any way that new replies could end up on top of the list as they do in other Groups? It would be easier to find and read them.
So my first question (I’m sure I’ll have many) is: My main reason for starting Symlin is weight loss/or prevention of further weight gain, and I understand it does this by creating a full feeling and by enabling us to use less insulin. (Though I have to say I was shocked to be gaining weight as I don’t use all that much insulin to begin with!). So I started by taking 15mcg of Symlin as recommended immediately before eating. I didn’t really notice any unusual fullness or lack of appetite, though maybe that happens when I get to higher doses. But I’m puzzled because I don’t think I’m an unusually fast eater, but when I eat alone so I’m not talking, I find it really is only about 15-20 minutes fo eat. Does the Symlin take effect that quickly that before I got to the end of the meal I’d feel too full to finish?
Hi Zoe -
First things first - every diabetic is so different, even without introducing Symlin into the equation. Second, Symlin is very complex pharmacology
Unfortunately, Jason has not been very active on Tu for a while, but what I did was open a Word doc and then copy and paste his guides so I had it all in one file - to which I add other notes or tips I run across…
Yes, I have heard that (for some) it can take a while for the Symlin to take effect in terms of appetite control but to tell you the truth, that’s not why I use it so I don’t even notice that effect. I eat very well and on the lowish side of carbs, so I don’t get that hungry. I take it so I can reduce insulin and lose weight that way. It’s not about how much insulin (I don’t take that much either), it’s about how insulin resistant you are and the fact that insulin can pack on the pounds.
If I am not low or going low when I get ready to eat, I will take the Symlin and then wait a few minutes to eat - nothing wrong with that. If I am low or going low, I will eat a little bit of food first, then take the shot, and wait a few more minutes.
Yes, I put the Guide in my favorites too, but I wouldn’t even have seen it if someone hadn’t posted the link in their Discussion, so I still think it would be a good Sticky.
Thanks, Cheri for your input. I don’t eat a lot either (or take a lot of insulin, Or have much insulin resistance. So why I’m gaining weight is anyone’s guess and pretty much pisses me off! LOL. I figured you had to be in the “eat whatever you want and cover it” camp to start steadily gaining weight! Whatever the reason, I want it to STOP, so I’m looking at the fullness, reducing food as well as reducing insulin…whatever
I’m also guessing that the plans for how to take the insulin won’t really work that well until I’m up to my maintenance dose. I decided to start out doing a straight bolus at the one hour mark, cutting the insulin by 1/2 and only doing a combo bolus if it is a meal I would do that for anyway. Doing that today I was at 222 at the 2 hour mark, so I probably don’t need to cut my insulin by that much since I’m only taking 15 mcg right now?
So far so good! I’ve been on Symlin for 4 days. Had a couple experiences like I mentioned above where I spiked higher than normal with 50% of my usual bolus. But had many more experiences of it working great! I’m guessing that I won’t really know what dose of insulin and how to take it until I’ve hit my maintenance dose. Good news is very little nausea! A brief moment or two of it the first day and nothing since! I’m currently at 30 mcg.
Someone mentioned today they’d heard that Kaiser had discontinued prescribing Symlin. I’m planning on switching to Kaiser for financial reasons during my open enrollment in November, but if Symlin works well for me I definitely want to be able to still take it. Does anyone on Symlin get it from Kaiser?
I’ve been on symlin now for about a month and I find, for me, timing is everything!! I take the symlin just before eating. if I have no insulin onboard, I take a small bolus for 3 carbs just to have a small amount of insulin onboard before eating. at 30 minutes, I take another bolus and take the rest of my bolus when I notice it rising. (I have a CGM and pump) so this works well for me. I have reduced my insulin intake by half. so if I eat 40 grams of carbs, I only take the bolus for 20 grams and break that up into usually 3 small bolus’, sometimes find I don’t need the third small bolus. it’s all in the timing and works well for you…I also read Jasons blog and found it MOST helpful, but waiting a full hour after my meal was too long and the HIGH got away from me before I could nip it in the bud so to speak, so I’ve been experimenting. I take a dose of 60 mcg of the symlin and this is where I’ll stay I think, it’s working well for me. experiment with the timing etc…and you’ll grow to love the symlin!!
Thanks, Debbie, for sharing how you’ve been taking Symlin.
I’m still experimenting with different timings. The only things I am definite about so far is that I take the Symlin 15 minutes before my meal so I get that feeling of fullness and eat less. I also have been aiming for 50% decrease of insulin and it works a lot of the time but not if I’m high to begin with or with meals I’d normally combo bolus for.
I’m also taking 60 mcg and that seems like the right dose for me as well which is what they recommend for type 1’s.
I started out with the one hour bolus thing and it works sometimes and sometimes I go high later so now I’m experimenting with a combo bolus. I’m going to post my results when I’ve found the method that works for me most of the time. Thanks again! I’m really excited about this medication!
I’m excited about it, too! i’ve been a full month experimenting with timing, etc…and I can see that once I get it down, it’s going to be a wonderful tool in managing my levels.
The one thing most need to remember is to bolus your insulin AFTER meals, not before…that is really the key and something your Dr. may not be able to tell you. Jasons 3 part blog is a MUST READ on this subject!! happy experimenting…I really think Symlin is going to be key for me!
Just a little background, I’m a fitness competitor, was 9% body fat when I started insulin (diagnosed type 1 at age 45), I gained 13 lbs in a very short amount of time once the insulin hit my body…arghhh. I was so depressed and frustrated!! so symlin for me, is a light at the end of the tunnel…I’ve already lost 7 lbs with symlin and using a lot less insulin, too. a win win!!!
7 pounds in a month?! Excellent! Yes, I can imagine that must have been frustrated to you, being used to being in such great shape. Strangely, I stayed the same weight (perfect for me) for the first year on insulin, then just in the second year I started to slowly and steadily rise despite continuing to eat moderate/low carb and never overeat or overtreat lows. I was really mad! When I reached 10 pounds I lookedfor an answer, and I think Symlin is it. I feel much better about it than diets or weight loss meds, because it is replacing a hormone we are missing.
Actually I have been experimenting with doing my insulin right before the meal if I’m high and that seems to work fine. My next step is to try combo bolusing right before the meal with a small amount up front, but I’m being very careful to make sure I don’t go low. It seems to take a lot of trial and error.
Question for you: Did you find you had to make any changes to basal one way or the other? I’ve been seeing highs at bedtime and morning fasting which are unusual for me. My basal has been really stable until I started Symlin. I know the bedtime can be for dinner. But even though some people talk about high morning numbers due to dinner the night before I’ve never found that happened for me. But maybe with Symlin? I’m hesitant to up my basals when they’ve been so perfect and the whole idea is to redce insulin!
One more question: Why did you switch from the combo to taking one dose when your bg starts to rise? The combo sounded logical so I’m trying that but not having as good a result as I did with the one shot (pump) thing. So I was wondering what you experienced. Thanks ahead of time and have a good Memorial Day. When I was working I loved those 3-day weekends!