Symlin May Be Mixable with Insulin After All

I know some people note that the pH of Symlin differs from most insulin, thus mixing in the same syringe as your insulin dosage is not necessarily the best means of administering Symlin (its not relevant for those who use pumps or pens) and could potentially be uncomfortable. However, I discovered an an article published in the journal American Journal of Health-System Pharmacy suggesting that mixing Symlin (a.k.a. pramlintide acetate) with insulin is allowable. To be sure, it was a small study, but is still an interesting possibility. To read the extract of that article, see below (unfortunately, without a subscription, only the extract is available - sorry!). I should also note that once again, this study was co-authored by several Amylin Pharmaceuticals, Inc. employees or partially funded by the company, but nevertheless, this might be a useful reference:

http://www.ajhp.org/cgi/content/abstract/62/8/816

Anyone have any thoughts on this? It has taken Amylin-Lilly forever to introduce a Symlin pen on the market. Apparently, they’ve been so busy making Byetta, that the smaller product (Symlin) really took a back seat in terms of dosing convenience. But rest assured, Lilly announced during Q1 and basically told investors the same thing again in their Q2 2007 Earnings release and presentation that they would be introducing a number of new pen dosing devices, and a Symlin pen is definitely in the works. In the interim, there is always a pre-filled syringe case, which can work for those who don’t want to lug it around while waiting!

My doctor mentioned the same thing, however, I don’t feel it’s a practical application. I have to be very careful about the timing of my insulin AFTER eating, sometimes way after eating, so I don’t go low. I’ve also had several instances where I’ve gone low after eating just from the Symlin before I’ve even considered taking my insulin yet. Seems like mixing would be a sure recipe for low blood sugar, at least for me.