I'm picking up my first symlin pen this afternoon and starting tomorrow at breakfast.

I follow a low-carb diet (specifically Dr. Beirnstein) and I was curious if any of you are using symlin and eating low carb.

I generally eat under 6g carbs for breakfast, and 12g for lunch and 12 for dinner.

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Great info, Mike. Looking forward to hearing more about it. Thanks!

How'd the last 2 weeks go? Were you really able to use less insulin?
Any issues as you up the dose?
I'm seeing my doctor tomorrow and I'm going to see if he'll prescribe it for me to try out for a while.

I'm using it now too. I've had a good couple of days on the ramp-up period. No nausea or hypos, and things seem to work as described. Today I'm going up to 30 mcg. I'm on a normal/low insulin dose and haven't seen the 50% bolus reduction to be totally accurate. I'm still needing most of my insulin bolus, but will be watching it as I go to a larger dose. Dr. Bernsten recommends a 30% reduction for people on his eating pan, and so far, that seems to work for me.

I'm giving a square bolus for 90-120 minutes to cover my meals, and using a CGMS to watch the effect. I bolus after I finish eating so I know what I was actually able to eat. My blood sugar stays the same for about an hour post meal, and then seems to rise a tad to indicate that digestion is happening, slowly.


Nice update. I agree that my bolus reduction wasn't as strong as I was advised...I think my doc was just really afraid of me going too low, so she aired on the side of caution.

I'm on 45 units with meals...and I feel a little nausea. Eventually my doc wanted me to go to 60 units, but after our last appointment she said that if I wanted to stay at 45 that's fine. My numbers are looking really good.

Yesterday I was between 80 and 120 all day.

I have been on symlin for nearly a year. I am type 1 and I eat low carb. A bit more carbs than Bernstein, but very low carb just the same. I am on the minimed medtronic pump and have the CGM. I use Apidra in the pump and my last A1C was 4.9. I love symlin, I take 120 mcg right before eating and then bolus within 10 minutes after my meal. If my meal has lots of protein in it and very few carbs, I will wait up to 20 minutes before I bolus. I usually use a dual wave bolus, meaning that I bolus upfront for the carbs and do an extended bolus for the protein and fat. I eat no bread, no pasta , I eat NOTHING that contains flour. (flour makes my BG uncontrollable) so I choose to just eliminate those things from my diet. I also, of course, eat no sugar at all....so yes, my diet is limited, but it is worth it to me to be healthy and fit. I eat lots of lean proteins, not a lot of fat. I eat very little fruit but lots of veggies. (green beans, asparagus and field greens, tomato etc. (no carrots , peas or high sugar veggies). you should all visit the TAG forum on here as there is valuable info there. remember that even protein and fat turn to glucose (a smaller portion of it) so you'll need to bolus for that also. I've learned a lot on here and am thankful to have a Dr. that supports my Bernstein low carb choices and she is very proud of my success. My A1C was 14.9 at diagnosis and I was near death. I am thankful for all the help I've received on here!!

That's great info Debbie. Did you find it difficult to go up to 120 mcg from 60? I'm at 60 right now, but wonder if I'd benefit from more.

Also, I eat Paleo/Primal and it looks a lot like what you described, but probably includes more fat. I'm getting good results too. It's the only thing that's worked well for me. Having a pump and CGM has made figuring out the Symilin part much easier.

I have scoped the TAG forum a bit, but with your recommendation I'll go read everything and get caught up. I know it's good stuff.

Thanks for adding to this discussion!

I didn't have any trouble going to 120 from 60..sometimes I do get some slight nausea but nothing that I can't handle and it only lasts a very short time. (very slight). I found the TAG forum to be most helpful so I know you'll learn a lot over there, too. I've learned over the past year that if I were to follow the ADA recommended diet of 30-60 grams of carbs per meal that my A1C would be a disaster. we must take control of our own health as I truly believe the ADA does not have our best interest at heart. I cannot fathom why the medical community is so resistant to promoting a lower carb lifestyle to diabetics. It must be so frustrating for Dr. Bernstein!! I credit him with saving my life and I thank goodness I read his book early on after diagnosis. I eat 30-60 carbs per day and those carbs are from healthy leafy greens, green beans or asparagus. I eat lean proteins and I find high fat foods give me a delayed high later on. it's a journey and if we are diligent, we all find what works for us.

I've only used it for 25g or more. Is there a particular reason you're using it when you are following such a low-carb diet?

I use it for any meal that I eat. I find that when I put anything in my stomach there is a glucagon release that counteracts my insulin and causes a rise. So, even a pure protein meal creates a disproportionate BG rise. Symlin stops that, and also causes your liver to release less glucose for about an hour or more. I find that it helps me regardless of carb count, post meal.
I eat about 20-40 grams of carb a day.




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