Trouble *staying* on Symlin or missing doses?

So I’ve been on Symlin for a while. And I got my dose all worked out and with the CGM it was pretty simple for me to adjust insulin and all that. My trouble was that sometimes I would go a day or two with no Symlin - either too busy to deal with it or doing something super-important and can’t risk getting nauseous or just not eating enough carbs to need it or whatever. Then, after a couple days off, I’m nervous about taking it again (esp. if I’m busy or at work) b/c I don’t know what dose I can do that won’t make me sick. Sometimes I take too low of a dose and it doesn’t work well. Other times, I take too much and get sick. Been through a bit of this and I’ve pretty much stopped taking it now. I’ve been real busy lately - working f/t and trying to finish my master’s paper and I’m sort of scared to go back on it because I can’t afford to lose a few hours dealing with a hard-to-treat low or with the nausea. But at the same time, I can see that I’ve definitely gone back to spiking after meals and I HATE that and am mad at myself for letting it happen when I could easily be preventing it.

When I’m taking my Symlin everyday, I LOVE it. There aren’t words for what a huge help it’s been for me. So it really bugs me that I’ve stopped taking it. How can I not want to do something that was so wonderful for me? I really want to be back on it, but am dreading having to work back up to my dose.

Does anyone else ever miss days with Symlin? If so, how do you adjust afterward? If you miss a day or two, would you take your usual dose when you go back on, or would you take a smaller dose? I use the 60 mcg pen, so can adjust my dose pretty specifically. Just never sure what to do in those situations and so sometimes I end up not taking the Symlin at all, which obviously is worse.

Thanks in advance. I’m going to bite the bullet and start back today. Wish me luck.

I can only speak for myself but I’ve had days when I forgot or I’ve been away from home at mealtime and haven’t taken my Symlin. A few months ago I got a bad cold and had no appetite so did not think it was a good idea to take the Symlin since my carb intake was way down. When I started back on it, I decided to take the lowest dose possible, which for me is the 60mcg. I am Type 2 diabetic and my usual dose is 120mcg. Like you I’m not real fond of being sick either and I’ve been taking Symlin since last October. The nausea for me never did go completely away, but I do like the control of after meal spike that I get with Symlin. In an effort to help control the after meal spikes I’ve started taking my meal time bolus about 10-15 minutes before the meal. This works pretty good for me since I’m also on the Omnipod. You have a very busy life with working on your Master’s. Best wishes to you.

Mayumi

I’m a type 1 and take 120mcg/meal. I have missed a day (full 24 hours) and only took 60mcg for the next dose, then back to 120 for the second with no adverse effects. I’ve been on it for several months and have no symptoms of nausea any more. I did have some of those feelings when i first started, but they quickly went away. My best advice has always been, have your food in front of you before injecting. that will prevent the lows and help any nausea. good luck!

I have not stopped taking Symlin for more than a couple of days since I started on it, but I did not have to acclimate again and did not experience any nausea when I resumed dosing. I just went right back to my 120mcg dose and all was well. I’ve read of people taking a month off and also having no issues resuming their normal dose. But everyone is different, of course. I’m sorry you’re having trouble- have you tried giving Amylin a call and seeing what they have to say?

i am not on the pump so will someone PLEASE tell this old time diabetic how mcg converts to units. i take 20 UNITS of symlin before meals. it works great - never been sick & never forget it. so what is this 120 mcg mean???

Thanks for all the replies. I took the 15 mcg dose earlier today and didn’t feel any nausea. So I’ll try the 30 tonight and hopefully be back up to my full 60 mcg before too long. Like Mayumi, my nausea never went completely away (but it was well worth it), so I might try to increase my dose more gradually this time - stay at a lower dose until the nausea completely goes away.

Cheery, check the web site for conversions between units of Symlin and mcg. I think 20 units is equivalent to the 120 mcg dose, but you should confirm that from the Amylin web site. If you use the Symlin pens (instead of a vial and syringe), the doses are in mcg instead of units.

thanks carolyn. i finally called my pharmacist. he said 60 mcg = 10 units & 120 mcg = 20 units. good luck. i really like finally having a “full” feeling & not as much hunger or cravings. still do the late nite snacks cuz of weird schedule.