Tuesday, February 27, 2007

Down (and maybe done) with Symlin

I may be giving up on Symlin. It seems that it has caused me more problems than the modest benefits it claims to give. At least, I am currently blaming Symlin for my increasing problems with hypoglycemia lately. Since I have begun training for my Ironman race, my insulin needs have gone down by about 30-40%, and my insulin sensitivity has gone up signifianctly. (My carb-to-insulin ratio went from 10-12g carbs: 1.0U inuslin to 17g:1.0 U and my correction factor from 1 U insulin for 60 mg/dL to 1 U for 95-100 mg/dL blood glucose.) I am exercising upwards of 14 hours per week, which means that I exercise in the morning and evening at least 3 days per week, and have a long ride and a long run on 2 other days. On the days that I exercise in the morning, it doesn't make sense to take Symlin except for lunch, possibly. And after a 4-hour bike ride, Symlin will not be helpful to me--I don't see large BG excursions, typically, after a meal on a day like that.

Of course, I may just be blaming Symlin for a severe low BG that spoiled my lunch-time run today. The first 40 minutes I was cruising along at a sub-8 minute per mile pace when--wham!--the low BG knocked me out. I had that spacey, "Uh oh" feeling and, after eating two gels (50 g of sugary goo), I still felt like I had to stop completely. I wouldn't have minded as terribly except that we had a freakish outburst of hail and there I was, standing under a big tree in the Golden Gate Park, unpacking my Ultra from the 2 too-small Ziploc bags, trying to dry off my finger to test. 41. Would it go up in 30 seconds? yep. 42. I finally got it up to 52 in about 10 minutes and decided to jog slowly. "Uh oh." I stopped and retested: 47. I downed another gel and waited another 10 minutes before deciding I might as well try to walk. At breakfast five hours earlier, I had taken my Symlin; as I stood there with my hands stinging in the wet cold, I recalled another very scary experience after taking Symlin, when I was unable to get my BG above 50 for a couple hours (and had to have IV dextrose administered). Unlike the previous experience, I had no nausea today; still, using Symlin burdens me with the fear that I won't be able to quickly recover from my low BG's. And I just don't need that.

7 comments:

Anonymous said...

Anne,

It sounds like you don't even need to be on Symlin! I haven't tried it yet, but if you aren't experiencing spiked postprandials, why were you put on it? Symlin would never "mentally" work for me. I have an overwhelming fear of getting low from previous experiences growing up on R and NPH insulin. Holy cow! Your exercise regimen seems to be taking care of it WITHOUT the symlin. Let us know what you decide.

Lindsey

Chrissie in Belgium said...

Maybe if I had postparandial highs I might be morre in favor of symlin, but as as I see it, it is justanoth confusing factor to deal with. Why not just work with exercise, insulin and carb choice. Why not just eat a complex carb over a high GI carb? Why not just add some fat to slower digestion. Another "medicine" seems just too complicated and it seems to make it impossible to get out of hypos! However I do not have postparandial highs - I choose complex carbs, healthy fats and exercise when necessary.

Scott said...

Perhaps a better way to look at it is that Symlin may not be appropriate for you at this point in time. But you may not be training to the same extent while you are training. However, there is something to be said for replacing all of the hormones (as well as C-Peptide) that type 1 patients lack, as there are benefits as far as keeping blood vessels flexible and reducing insulin requirements (excessive insulin is attributed to many complications in type 2 diabetes) which reduces the incidence of some complications even further.

Of course, none of this is quite as good as functioning beta cells, but I would agree that your need for Symlin is not as great as it once was. Consider revisiting the issue again down the road!

Anne said...

Hi there,
I think you all have good points. I chose to use Symlin after noticing big spikes after breakfast using my Dexcom. And the Symlin has helped with this. And I also noticed that it seems to help with my appetite (eg., I'm not hungry 20 minutes after eating breakfast). Right now, though, it does seem to be just complicating things.
And Scott, you are right--I won't be training with this intensity forever, so it may be worth revisiting once more in the future.
I do also agree that I'd like to replace whatever hormones are missing. Sometimes I wonder--despite taking Humalog for years--whether injecting an amylin analog (i.e., Symlin) is the same as replacing amylin. I guess it's as close as we can get.

Thanks for your comments and suggestions...
-Anne

johara95 said...

I have tried Symlin twice.
I have various problems from low sugars to high sugars to mood issues.

I have decided to use symlin more as a suppliment at dinner rather than a therapy.

I think the drug companies are trying to get us to take more of this hormone then we need.


Our bodies are supposed to have some of his hormone each day.
will let you no how it goes.

johara95 said...

I have tried Symlin twice.
I have various problems from low sugars to high sugars to mood issues.

I have decided to use symlin more as a suppliment at dinner rather than a therapy.

I think the drug companies are trying to get us to take more of this hormone then we need.


Our bodies are supposed to have some of his hormone each day.
will let you no how it goes.

Ethan Turner said...

I have been on Symlin for one month now. I am active (weight training in winter, swimming, biking, running in other seasons). My primary motive for using it is weight control. I use either an injection of Novolog or regular insulin as a bolus and Lantus as long-acting. For me, the effect of combining Sylmin and Novolog has proven to be too fast for most meals -- I typically get a low (~50) after 2 hours, correct it, then end up high (~150) after four hours because the combination of these drugs has little effect on blood sugar after 3 hours.

Symlin plus regular insulin has proven to be the best combination in most cases, since it leaves enough of a tail to cover what happens in the 2 - 5 hour range. As far as weight loss goes, it will take a few months to determine if there is a benefit there.