My Symlin Journey

 When I started on symlin nearly 2 months ago I was incredibly concerned about the nausea since that was the single reason I dropped out of the clinical trial the first time I was on symlin. The second time I was on it I experience some nausea but nothing like the first time. One month in I was happy to report that I barely had any nausea. A few weeks later I went up to the maximum dosage, 60mcg.

It has now been a little over a week that I have been taking the maximum dosage of symlin. I'm happy to report so far so good! Had somebody told me back when I was a part of the clinical trial that I would be doing so well on symlin and, gasp, happy to be on it I would have thought you told me the world was flat.

I'm incredibly insulin resistant and have been since day one of my diagnosis. Because of this insulin resistance I was willing to try symlin again. The incredible thing is my insulin requirements have drastically dropped.  My basal rate is still pretty high (from 11am to 10pm it is 3.7 units/hour) but my insulin to carbohydrate ratio has really changed.

Before symlin: Breakfast 1unit to 5 carbs (1:5)  Lunch and Dinner 1:4

60mcg of symlin: breakfast 1:17  lunch and dinner 1:15

That is a huge difference for me. A couple days ago I was talking to my mom about all this and she said that she remembers when I went on the pump in 1992 and started carb counting I my ratio was 1:15 but quickly changed to 1:10.

Not only are my insulin requirements going down but so are my numbers. Like drastically coming down. My one week average is 113 mg/dL which is fantastic. My biggest issues are lows after eating. I can't really treat the low because then I rebound and go high. If my number is too low before a meal (80s or bellow) I don't give myself symlin. Luckily, I haven't gone terribly low. My Dexcom has helped a lot with that because I can physically see what is happening with my blood sugar and act accordingly.

My appetite has also decreased, which is a pleasant side effect. The thing with symlin is if you overeat in the slightest it makes you feel disgustingly full. I am optimistic that this is helping with my weight loss goal.

On Monday Steve and I went out to dinner. We opted for Indian. I went to give myself the symlin and realized it wasn't in my purse. So I was careful about counting the carbs I was eating and watching my numbers. Tuesday morning I woke up high (180-220). It was the first time in a week or longer that I was over 160. It showed me exactly why I should be on symlin and how much it is helping me .

I'm well aware that symlin is NOT for everyone but it has been great for me. In about a month I'll have my A1c retested and hopefully it will be lower (based on my meter averages I can guarantee it is lower) which I attribute to the symlin.

Quick Update

Tuesday I had my appointment with the Physician Assistant/Diabetes Educator at my Endocrinologist's office. I've been in the office at least once a month since October.  It really helps me to be accountable and stay on track.

The PA/CDE and I go through my logbook . "You are still running high mid to late afternoon." So we raise my basal rate during that time by 10%. "If you can keep your blood sugar from going high in the evening you wake up with a good number. This change should help. "

"The symlin looks like it is working well for you. You can go ahead and go up to 60mcg if you want but just keep an eye out for lows."

I left with the overall feeling of success. My 90, 60, 30, 14 and 7 day averages have all dropped. My 14 day average is awesome. Feels good to come out of the appointment being told I was doing a good job. I think if I had my A1c tested today it would be lower, not where I want it to be but at least in the right direction.

Then yesterday I wake up to an upset stomach yet I managed to keep my blood sugars on track despite being sick. I'm feeling better today but not 100%. Today I'm keeping it low key.  Sorry for the boring post.

Symlin Update

As promised an update on round 3 with symlin. For a recap on my experience with insulin read about it here.

I've been using symlin for the past month. Overall it has been great. The big side effect I dealt with in the past was nausea.

Nausea was the single reason I quit the trial the firs time around. The second time around I would have a nausea for the first few days of each new dosage. This time... no nausea. Well, that was true until this past weekend when out of nowhere I started to have some nausea. On Saturday Steve and I went out to breakfast but after eating left felling like I had swallowed an entire cow and felt nauseated for the next 2 hours. Sunday it was the same deal after brunch but this time it only lasted about an hour. Since Sunday I haven't had any nausea. Weird, huh?

Dr. A was concerned about going too low after eating so she only wanted me to go up to 30mcg before each meal. At my appointment with the PA/CDE she had me go up to 45mcg and change my carb to insulin ratios.

Immediately after eating my numbers are pretty good. In general my biggest problem is 3 hours after eating. the PA/CDE said that that is a result of basal issues but I'm thinking that when I have a carb-heavy meal I go up 3 hours after eating.

I'm using less insulin overall with is a big reason why I wanted to go back on the symlin.  So far I'm really glad I'm using symlin.

I see the PA/CDE in about 2 weeks and I'm hoping she'll let me raise my dosage. I'm reluctant to raise my basal anymore. As it stands I'm already on a ton of insulin and needing to refill the reservoir every 24-36 hours. Yeah. It stinks.

Symlin

I guess you could say I have a bit of a love/hate relationship with Symlin. A while back my endo growing up, Dr. E, took part in the Symlin clinical trial. He absolutely loved the results he saw with his diabetes control not to mention the weight he lost without trying. With his success he thought I would be an ideal candidate for the trial.

Reluctantly I agreed to be a part of the trial. There were two issues that I had: the nausea, dear god the nausea, and having to take 3 shots a day.

One of the side effects of Symlin is nausea and boy oh boy did I have it bad. I was never able to increase my dosage because I just could not handle the 2.5 units (15mcg) at all my meals.

More importantly, at the time I was furious that there I was on the insulin pump having given up countless shots a day to only 1 shot every 3 days. Admittedly, I was not giving symlin the fair shot it deserved. Apparently I was one of a few people in the study across the US who dropped out of the study.

About 2 years ago I talked to Dr. E and decided to give symlin another try after hearing how many people liked it and the results they had with it. A big selling point was that it was now in pen form so I would have to carry around a bottle of symlin and syringes. So I gave it another shot (no-pun intended) hoping my results would be better.

More than anything the nausea is what concerned me. Luckily after 2 days the nausea was gone. My problem with it at the time is that I was eating low-carb and not enough carbs in a meal to take the symlin (you have to eat 30 grams of carbs) so I ended up with some not-so-fun lows.

On Friday my new endo, Dr. A, and I decided to give symlin another try. I've always been so incredibly insulin resistant and have been since my diagnosis 21 years ago. For most of the day my basal rate is 3.1 units/hour. Yeah, it is a lot. I'm on so much insulin and I really need to drop some pounds. Perfect time to start symlin again.

The pharmacy didn't have symlin in stock but I  picked it up today. I'm hoping third time is the charm. Over the next several days/weeks/months I will be commenting about my experience with symlin. Please note that I am not being paid or am I associated with Amliyn Pharmiceuticals.

For more information on symlin please visit their website and contact your doctor if you think you would like to try it.