T2 on Symlin - Cut Dose in Half

Well, I’m still learning…one thing I can say is that things always change with diabetes. I started Symlin about 6 weeks ago, I guess. My reason was to reduce the amount of insulin and thereby lose weight. Adding insulin and a low carb diet a year ago allowed me to really gain tight control (5.4 A1c), but it “cost” me about 20 pounds, and a vicious cycle of insulin resistance - something I already struggled with.

Right from the start, I had a really good experience with the Symlin - no nausea at all - and was able to build up to the T2 dosage of 120 mcg in short order, reduced my insulin by half, and lost 10 pounds fairly quickly. No hunger - literally - was a bonus although since I was on low carb already that’s not usually an issue for me. Since I’m on MDI right now (going to the pump soon), I can’t do a real square or dual wave bolus so I time my bolus for about an hour after eating and then watch to see if I need any more at 90 minutes. Worked like a charm.

However, in the past couple weeks, my 2 and even 3 hour pp readings started going higher and higher, requiring extra insulin. I couldn’t figure it out and couldn’t seem to get a handle on it, even though what I was eating shouldn’t have caused this - it was driving me crazy! Had the Symlin lost it’s effectiveness?

Well, I felt like a dummy, but it finally hit me - I was having a day time somogyi-type bounce back effect. In other words, I was going too low after eating and my liver was dumping extra glucose to overcompensate. Doh!

So, I cut back my Symlin by half (60 mcg) and things seem to be back to normal, but I’m still testing and watching to make sure.

Anyone else had this issue?

Hi Cheri
I too had problems with the high dose of symlin. But now I find myself with lows either at 3pm or 2a.m… But I also have been sending my BG machine to my endo every two weeks. So far he hasn’t downed my dose yet. But hopefully I find a common grounds.

I now have to work on getting my foot elevated since I had surgery on it today and also have a broken bone in also now. What will go wrong now with me??

Take care Cheri

I’m a T1 on Symlin. I was also at 120mcg at one point, but as I lost weight, my insulin resistance decreased so I required less Symlin. I am now on 30mcg and still loosing some weight

My dosage is now 60…I take it 20-30 minutes prior to eating… (3x a day). When I started my endo said I had to cut my insulin in half or I would go too low!
I’m on the Omni pod…so everything is all set.
I am a small framed person, very insulin sensitive, and Yes, YOU HAVE TO COUNT YOUR CARBS.