Symlin Losing Effect

Treatment Oral Medications and non-insulin injectables
1

Has anyone else experienced Symlin losing effect? Formerly I have taken 30 micro-units, now just upped it to 45 for the “full feeling effect”. While taking 30 over the last month I might as well have not even been taking it. What scares me about this is it losing effect completely! What happens when I need 60 then more than that. The pen doesn’t even go above 60! I have only been on it for about 5 months now.

My question is, do you think this is just the body getting use to it and adjusting to what would otherwise be a “normal level”. So I adjust from 30 to 45 then maybe 60 and that just levels off there. The level my body should be producing anyway? Thoughts? Has anyone upped the dose then it just remains constant for a long period of time?

2

There are 120 pens - I know some say only T2s should take more than 60, but there is no “rule” about it - Jason, the guru of Symlin was a T1 and took 120.

Of course, I guess it matters why you take Symlin. I take it mostly to be able to reduce the amount of insulin I take as I am highly insulin resistant - so insulin puts weight on me.

I find hunger only occurs when my BG rises, so I work very hard to “stay within the lines” because there’s nothing more terrible than that terrible, gnawing, blood sugar “false” hunger.

3

i think on the paper in the box, it says 20 UNITS per meal. at one point - a year ago, i felt i had become immune to it. i went off for a month or so then started back on. i have been very regular since then. but - i take 20 for breakfast (about 1pm, then again for dinner about 7 pm. i know, weird schedule but it works for me. the full feeling stays with me but i have to watch my late night cuz i stay up late & will nibble. just read the info, i guess.

4

I should have added that I vary the amount I take based on the number of carbs in a meal - fewer carbs, lower dose - more carbs, higher dose.

So far, my max is 60, but if needed, I will certainly think about a higher dose.

5

How do you give yourself 20 units if the pen only allows for 15, 30, 45…?

6

That makes sense… How long have you been on it? You still feel the effect is the same?

7

Well, this time, I have only been on it for about 2 months. Yes, I still feel the same effect and it certainly does curb appetite in terms of in-between meal snacking - but I really think a lot of that comes down to what you choose to eat. I stick to good, quality food - no empty calories - and complex carbs. That helps.

8

Symlin is available in a vial - but I thought I read they were discontinuing that?

9

i dont use the pen. i do bottles & needles.

10

I’ve been wondering the same thing and just put a call in to my nurse about this exact question. When I began symlin my i:c ration went from 1:10 during the day to 1:16 but now I’m right back to 1:10 and still going high for about the last month. I’ve been on symlin since september and use 120 in the pen. I’m really frustrated and feel like I’m taking another med for no reason.

11

I’m frustrated , too. my BG stays super low after a meal, but then 2 hours later…BOOM…a spike of 180 and higher!! the whole point of symlin for me is to take less insulin (because you take 50% insulin bolus), but if i have to take a huge bolus 2 hours later to get my high down, I’m really not taking less insulin at all. frustrated!!! can anyone help?

12

DON’T GIVE UP! It’s complicated and takes time but here’s the thing - you MUST wait to take your bolus. The pharmacology of Symlin is complex - basically, it is a drug-induced form of gastroparesis (delays digestion). So, think of it this way, when you get that big spike, it would be as if you took your BG right after eating.
None of the RX literature will tell you this, but it works best if you wait until your food starts to hit - THEN take half. With some things, I do a combo bolus (I have a pump). And I vary my dose between 30 to 60 depending on the # of carbs I ingest.

To repeat a previous post -
It should be noted that I DO NOT take Symlin the way the doctor or the literature suggests - I know that’s not a big surprise to folks who have been hanging around Tu for awhile. We have to find our own solutions and share tips and tricks, so to speak. However, thankfully, Jason did a lot of the work for me. I suggest that anyone considering Symlin read through his 3-part blog post - it helped me a lot. http://www.tudiabetes.org/profiles/blogs/a-practical-symlin-guide-for-1

13

Thanks so much for the link! A lot of good info there…I think I’ll try the combo bolus and see what happens. Would love to get my insuin to carb ratio down so that I feel like the extra injection is worth it

14

Yes, the Symlin website says the vials have already been discontinued but they predict there will be supplies available for a few months. But then, that’s it.