I started using Symlin recently and I wanted to share my experience. The following article by Gary Scheiner, a diabetes educator, is a great instructional guide to using Symlin and avoiding devastating hypoglycemic events.
Symlin is a hormone released along with insulin by the beta cells of the pancreas to do two things:
1. Slow down the emptying of the stomach.
2. Temporarily blunt the effects of glucagon which is inappropriately released after meals in people with type 1 diabetes causing release of glucose from the liver and muscles despite the intake of food.
My experience with Symlin has not followed that of most users. First, I have never felt nauseous after injecting Symlin and second, I have not found the injections painful. From time to time, I’ve noticed a slight stinging under the skin after an injection, but nothing dramatic. I have noticed a mild reduction in appetite while using this drug, but far less than some of the reports I’ve read out there. I can still put away enough food to turn heads from time to time so I’m thankful for any improvement in this area.
When I first started taking Symlin, I was told to reduce insulin by 25% to 50%. I’ve notice I’ve had to reduce OVERALL insulin by only 25%, but more importantly I’ve had to play with the timing of that insulin.
On one of my first days with Symlin, I took 60 mcg of Symlin and 2 units of insulin ( 50% of usual dose) 5 minutes prior to eating dinner. Then, my wife and I went for our usual 1 mile post dinner walk around the neighborhood. Upon returning, my blood sugar was 40. I took a couple of glucose tablets to correct this low blood sugar and it took an unusually long time to take effect due to the slower stomach emptying effects of Symlin. Finally, a few hours after eating, my blood sugar was too high.
My first experiment with Symlin was not fun, but I assure you there are long term benefits to persevering through these first few days and getting it right. The elimination of BG spikes is important. And, for those athletes out there, it’s nice to hold onto muscle and liver glycogen when not training. In addition, I like having less insulin running through my blood at any given time.
Here’s a routine I’ve found that works for me. Figure out how much insulin is needed for a meal without symlin and reduce it by 25%. Then split that dose in two and take the first does before dinner and the second does after dinner. Be very careful if you plan any kind of physical activity after eating. This could cause a severe hypoglycemic event that is difficult to recover from.