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Permalink Reply by Aaron on May 17, 2011 at 6:33pm

Maureen,

I did, in fact, figure out a rule of thumb for myself. I treat the Symlin as having full efficacy for about two hours. I then basically treat the Symlin like it loses about half of its efficacy every 40 minutes of the next two hours (basically like a 40 minute half-life). So, at two hours after an injection, I would still take 50% of the insulin. At three hours, I would take 80% of the insulin. At four hours after an injection, I would take 100% of the normal insulin dose.

I found that I maintained much better post-meal readings when using a square bolus. If I took a normal bolus, I would consistently end up going low a couple of hours after the mean. Even with the square bolus, I found that taking the insulin after the meal (as unconventional as that might seem) prevented lows that I would get when taking the insulin before the meal.

Good luck getting acclimated to Symlin treatment.

Permalink Reply by MaureenH on May 17, 2011 at 7:05pm

Your answer is interesting. I have been taking half the insulin up front, no square wave or I go low, and then the other half plus perhaps a little more at exactly 2 hours. You also mention the two hour mark. Maybe doing the insulin at the end of the meal would help but I am so used to doing it before I am afraid I might forget at the end. I need an alarm at the two hour mark. Maybe I can set a BG reminder alarm. Now I watch the clock because I have the CGMS and I see the rise at two hours. How do you know how much symlin to use? I am at 45mcg. I think that is my level. I tried the 60 but went low too often.

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