Symlin questions

I’m trying out symlin. So far it’s working well, but I’m still trying to figure out the dose timing and practicalities of taking it.

What do you do when you eat two meals/snacks, say, two hours apart? Do you take another symlin dose or not? How long do you find the effect lasts after a symlin injection? And: how far ahead of eating do you take the symlin?

You take Symlin at mealtime, a meal that consists of at least 250 calories or 30 carbs. I am having a late snack of peanut butter and grapes. I bolused for them, but didn't take a dose of Symlin. At dinner, later tonight, I'll take the Symlin.

I typically pre-bolus and take my Symlin then.

I wouldn't take another dose unless three and a half to four hours has gone by.

It's worked well for me, primarily by greatly reducing BG spikes after I eat, while taking half the insulin.

Yeah, I’ve read the prescribing information sheet, and I’ve been using it for a week now, with considerable success (at preventing big post meal spikes). I’m just curious about the details of what more experienced folks do, in practice.

I don't know if I am a typical user, but I've been on Symlin for two years now with great success.

You were asking about snacks and it was funny (for me) because just at that moment I was eating one and knew that lunch had been about three hours earlier and dinner was going to be in a few hours. Speaking of which, it's time for dinner!

If I can help with anything else, just ask :)

Haha, thanks! Hope you enjoyed your snack. :)

Do you use a different, higher ICR/bolus rate for when you're not using Symlin (e.g. the grapes)? And do you take it for big fatty meals that normally wouldn't cause a spike anyway, or not?

Excellent questions!

No, I don't have a different ICR when I'm not using Symlin. I intentionally paired the grapes with peanut butter to help ease the spike. Which fits in with your next question about bigger, fatty meals. I don't change the ICR or my dose of Symlin when I have a higher-fat meal. I wear an OmniPod though, so I am able to change how the bolus is delivered and I do extend my insulin dose with a higher-fat meal.

One would think Symlin would help with a snack, like grapes, just like it does with a full meal, but there must be some residual benefit that carries you close to the next meal. I know I didn't spike yesterday :)

I wasn't much help with this, but as I said, excellent questions! I know I will be paying much more attention to see if I notice anything that I might not have made the connection to before.

No, that’s very helpful, thanks!
In case you’re interested, I just asked my doctor about the action duration. He said the half life of symlin is about 45 minutes, but the tail hangs around until about 4 hours. So your residual action idea certainly seems likely (and that would be an additional reason for taking it consistently at every meal).