Starting Symlin Next Week

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Permalink Reply by Cheri on October 1, 2009 at 2:58am

I hear ya, Marty. I, too, have gained about 20 lbs just from the insulin. I started symlin a few days ago - definitely notice a difference in amount I can eat - but this was never an issue since I low carb it I don't experience a lot of hunger. All I want is to reduce my insulin and thereby, hopefully, lose weight. By the way, I'm up to 60 mcg as of yesterday and I'm NOT adding in more carbs than I was eating. I've seen that advice, but most don't notice that it says 30 carbs OR 250 calories...so I'm going for the calories...I'm not going to add more carbs and undo everything I've been doing to get a 5.4 A1c!!!

Let's keep in touch as we go on this journey.

Cheri

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Permalink Reply by marty peters on October 2, 2009 at 12:36am

I shall stay in touch as I began this journey and keep you posted on my progress. Since i am a Type 2 I have the pen with either 60 or 120 MCG. I am starting with the 60 mcg with my biggest meal of the day for 3 days or so. After that proceed to 120 mcg before any meal with 30 carbs or more.

My concern was what to do before excercising especially high intensity. My Endo said to skip the shot....

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Permalink Reply by marty peters on October 6, 2009 at 3:22am

Well I am back from vacation and starting my initial dosage of Symlin later today. I work 3rd shift so I have chosen with start with breakfast which is 9 PM.

I am anixous to see how I will react. I did have mild sickness with Byetta when I started it.

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Permalink Reply by marty peters on October 6, 2009 at 11:28pm

Well, after my initial dosage of Symlin my pre-meal BG was 130.....my post-meal BG is 184. That is not what I expected but only the inital dose. I do have a bit of a sour stomach feeling.

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Permalink Reply by Cheri on October 7, 2009 at 4:49am

Hi Marty

What dose did you start at? I started small, but quickly progressed. I'm now at 90 and will probably take it higher, at least for awhile. Did you see Scott's post in the Symlin User Forum? He's a T1 who was on 120 mcg but found over time, as he lost weight, he had to reduce his Symlin - makes sense to me. Less weight, less insulin resistance.

I just remembered that while I did notice the appetite and satiety affects right away, I did NOT notice a significant impact on my BG or the bolus needed until I got up to 60 mcg - and a dramatic impact at 90 mcg. In other words, I had to take a bit more than half my normal bolus until my Symlin dosage built up, and I had to do a few corrections at the beginning. Of course, everyone is different - and I'm an insulin dependent T2. After 18 years, finally needed insulin about 9 months ago.

I also find that I need to take the bolus about an hour after eating. If I take it with the Symlin, there's too big a risk of a hypo and I'm "guessing" about how much insulin I need. So, I check BG at 1 hour, then bolus (~70% at the beginning, now at ~30%). Then I check again at 2 hours and do a correction if needed (now at 90 mcgs, I'm not needing a correction)

However, because I'm a low carber, I never have more than 15-20 carbs per meal (much less in am). If I did, I'd have to take much more insulin and would probably have gained even more weight from insulin!

BTW, Jason's guide states guidelines as at least 30 carbs per meal BUT I noticed that the Symlin literature states at least 30 grams of carb OR at least 250 calories - so I'm going with the calories. Just not willing to go back to carbs - they create hunger - and my A1c last month was 5.4%. Low carb works.

Take care.

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Permalink Reply by marty peters on October 9, 2009 at 4:18am

I am at now the max dosage of 120 mcg before each meal of more than 30 carbs. Interesting results. I used about 30 units less insulin yesterday than I normally average. My post-meal BGs have been good. I still have a sour stomach feeling but not too bad. I can say my appetite has been affected........

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Permalink Reply by marty peters on October 13, 2009 at 12:08am

It's Tuesday, October 13.....I have been on Symlin for about 7 days. I have lost 5-6 pounds. The sour stomach feeling is getting less and less. I am finding that my food cravings outside the 3 major meals of the day are almost non-existent. I believe this has been a big help in the weight loss so far.

Only one scary moment.....my BG reached a low of 59 and I really didn;t feel any side affects telling me it was low.

I have been cautious with starting my excercise routine I had before. I normally have 4 60-minute high impact aerobic sessions a week plus weight-lifting the other 2 days each week. I plan on restarting next week.

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Permalink Reply by Cheri on October 13, 2009 at 5:25am

Congratulations, Marty! I'm about 1-1/2 weeks ahead of you and I have also lost about 6 lbs!

I haven't experienced any lows quite that severe but have had a few morning lows in the 60s. I'm trying to slowly adjust my basal doses (I'm not on the pump).

I have also waited to return to exercise. I'm going to start back slowly, and also think I will switch from mornings to afternoon/evenings. I seem to be more susceptible to the boomerang effect in the a.m.

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Permalink Reply by marty peters on October 20, 2009 at 10:26pm

Well, Week 3 of Symlin and it's a mixed bag. My cravings have stopped between meals with Symlin. The downside is my post-meal results after 2 hours are still high.....170 - 199. I was expecting these to be lower since I am eating less carbs.

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Permalink Reply by Cheri on October 21, 2009 at 5:24am

Hi Marty - something interesting I noticed is that when I take my Bolus either with the Symlin (as the literature says) or shortly after, it was like I was "wasting" the bolus - it had no effect either way. After checking my BG for a few days before eating, and then 1/2 hr, 1 hr, 1-1/2 hr, and 2 hours after, I learned my "rhythm" - in other words, when my BG started the climb back from the delay created by the Symlin. For me, it's about 1.5 hours - that's when I take my bolus and I avoid the highs. So Symlin covered me while I ate and for a while after. Just an idea. So far, it has worked.

Also - what dose are you on? I had to go to 120 mcg to get the full benefit.

How is exercise going?

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Permalink Reply by marty peters on October 23, 2009 at 12:44am

That is most interesting......I just checked before Symlin and after Symlin stats and quite surprising. My 2-hour after eating BGs were higher across the board. Since they were in the 180s before Symlin that is disappointing. My before meal BGs are better but still in the 166-181 average....not good.

I like your idea of delaying my bolus till afterwards. At this point, I am going to give it a try and see how it works. Today I didn't eat for over 11 hours and upon waking up this evening to ready for work my BG was 212! This was a big discourgement.....

The excercise is not coming along as well as I like......I am having side issue with Lipitor causing muscle faigue that has me concerned. My primary doc tripled my dosage about 6 months ago and I have complained about muscle aches/pains but it was infrequently. Lately it seems like everyday and excercise makes it worst. See the doc next week so I going to ask for an alternate drug to replace Lipiror. But hey my cholestrol, LDL, HDL and TRI levels are in great shape!

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Permalink Reply by Cheri on October 23, 2009 at 3:34am

Hi Marty - Sorry to hear about about the ups and downs. You know, going back to your original post, I just have to ask, do you really think it was eating that put the pounds on? It's just that so many medicines can do that, too. Or, they can cause overwhelming hunger that leads to eating.

In terms of the Symlin, I honestly don't know if it will lower your overall #s if your BG before meals is on the high side. I just don't know because I was fairly well regulated before I started the Symlin....and the only way I got regulated was by going way, way low carb....which also took away my hunger for the most part. So, for me, taking Symlin was about reducing my insulin, which in turn, reverses the weight gain.

I hear ya about the Lipitor. I took a statin drug late last year and it was AWFUL. The aches and pains and fatigue made me feel 100 years old. After some research, I refused to take it. I also stopped buying in to the "big lie" of going low fat and instead went low carb (which is not low fat). When I did, my BG came under control and all my cholesterol numbers fell to perfectly normal #s. So, it's high BG that can lead to high cholesterol. Even my doc couldn't believe the difference in my #s. I also went from an A1c of 7.9 to 5.4.

I thought this was interesting - http://docnews.diabetesjournals.org/content/4/12/1.1.full
This is interesting as well - http://www.mayoclinic.com/health/statin-side-effects/MY00205 - it seems diabetics are more prone to the side effects. I have talked to some people without diabetes who say they don't have side effects, but for me, I decided I did not want to live that way - not feeling like myself.

Speaking of that, my biggest issue is the Dawn Phenomenon - I'm seriously considering the pump so I can sleep without being wakened by the sweats at 4 am!!

When you say you didn't eat for 11 hours and your BG went to 212 - that would make me wonder whether your basal rate is set correctly. It should cover you when you're not eating. I'm also curious about your bolusing - aren't you on the Omnipod? I assume you are carb counting? I'm just surprised by the highs - for a T2. I hate to play the broken record, but one of the reasons I went low carb was because not doing so made it so much more of a roulette game to control my #s.

One last thing - have you read Jenny Ruhl's book, or visited her site? Very, very helpful to T2s - http://www.phlaunt.com/diabetes/

Take care

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