Starting Symlin Next Week

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Permalink Reply by marty peters on October 23, 2009 at 4:13am

Dear Cherie,

That's for the info and support. The introduction of Symlin was too level out the post-meal spikes as well as the possibility of weight-reduction benefits. I do have a history of when my diabetes is in control of weight-gain being a problem. Currently, I limit each meal to about 45 grms of carbs. In fact, the example I listed I had only 40 grams. While taking Byetta I lost 40 pounds but my diabetes was not in good shape. Hence, the insulin came back into the picture and 40 pounds back on.

Being a T2, I am stunned at the amount of insulin I take daily......about 90-95 units. I am perplexed by it. I normally get this reaction when I mention my insulin intake...WOW!!!!!! When people say that I feel so guilty as to ask myself what am I doing wrong.

I work overnight and I still get the Dawn Phenomenon around 4 AM. I thought being awake already would prevent this but you can't overrule Nature I guess.

Thanks for the resources....I will check them out.

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Permalink Reply by Cheri on October 23, 2009 at 4:59am

Hi Marty - Don't let people make you feel guilty! I look at all of this like some kind of weird puzzle or mystery - and figuring out all the pieces is so individual...although it's been so helpful to learn about what others have tried.

Interestingly, I think Byetta is made by the same folks that make Symlin. Wondering what you took in addition to Byetta when you were off Symlin. Also wondering, when you say, 90-95 units per day, and you're on the pump, whether you think the pump is helping you and whether you are happy with how you have been able to fine tune it to your needs.

As far as low carb, I guess that means different things to different people - but I'm talking about somewhere around 40 grams of carb ......... for the whole day! It was only then I got control. I finally had to get that, for my body, carbs are poison.

As long as you're still asking questions and exploring, I'm sure you'll find the right answers for your body.

Yeah, that DP sucks...my rise is not that dramatic but the sweats interfere with my sleep.

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Permalink Reply by marty peters on October 23, 2009 at 8:07am

I was taking a very low amount of Lantus (30 units) in conjunction with Byetta. The carb count is following the diet from the endo to limit carb serving to 45-60 carbs per meal. This includes all fruit and dairy products as well. An example would be breakfast of 2 eggs, turkey bacon, 2 slices wheat bread and a banana. That's about 40 grams of carbs.

When I started the pump last May the numbers I was getting was terrific. I got sick in early July for about 3 weeks and my BGs have been on a roller coaster since then.

The one thing I am starting to worry about is insulin stacking. I do notice the 2-hour after eating I still have a large pool of insulin on-board at times. I am crafting a reporrt for the endo to fax him today to recap this crazy week, He responds pretty quickly to these.

Overall, I really like the Omnipod in place of MDI.

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Permalink Reply by Cheri on October 24, 2009 at 5:54am

I love my Endo, but I just don't count on her or their office for diet advice. As someone here at Tu said to me, we have to learn to be our own doctors and Diabetes Educators.

2 slices of wheat bread and a banana would put me way high unless I loaded up on insulin, which I do not want to do. What I've learned is that maintaining good numbers is almost impossible while eating a "normal" amount of carbs. It makes it much more hit and miss, up and down. And, of course, the more insulin, the more weight (my theory is this is much more true for T2s who tend to be incredibly insulin resistant).

Since I'm not yet on the pump, I don't know about insulin stacking.

Although the first week is sometimes a challenge, I encourage you to at least try very low carb - I think you would be amazed. It's also a meat lovers dream. Forget turkey bacon - get the real deal! And, no more low fat crap - real butter, real mayo, real olive oil (avoid veg or canola oil)

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Permalink Reply by marty peters on October 28, 2009 at 3:19am

I did the low carb several years ago.....the downside for me were elevated Tri, cholestrol and LDL levels. I am not sure what to do going forward. The endo change my IC from 1:10 to 1:8 while using Symlin. To date, I am not sure Symlin is worth taking.

Permalink Reply by Cheri on October 28, 2009 at 3:30am

Wow - just the opposite happened for me on low carb - all my cholesterol numbers were dramatically improved.

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Permalink Reply by marty peters on October 28, 2009 at 11:29pm

I thought the same thing as I had heard about that. The only thing I determined was that heart disease is rampant on my father's side of the family. So genetics may being playing a large role here.

I am going on vacation for a few days so afterwards I am going to do a total re-assessment of my health and determine the next courses of actions including maybe trying low carb again and see. My 3 objectives are:

Diabetes under control
Cholestrol/Tri under control
Lose Weight

All 3 can be achieved I just need to figure out the lifesytle changes working with my doctors to reach these.

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Permalink Reply by Cheri on October 29, 2009 at 4:14am

I hear ya. It's just finding the right answers for you.

Heart disease is in my family too, but then so is carb overload, so who knows. Heavy carb intake was just a way of life in my family - and diabetes is rampant in my family as well.

What I don't know is how well low carb works when you're taking statins. Also, I'm assuming you have had thyroid tests - TSH, T3, T4?? If not, definitely get that done - I am hypothyroid (Hashimotos) and that affects weight as well. Tip - do the test when fasting. Some say it doesn't matter but my research says otherwise. And, diabetes and Hashimotos sort of "go together" very often.

So far, I feel pretty good about the Symlin in terms of the reduction of insulin needed - which was my primary goal - and losing weight secondarilyC, which is happening as a result of the first goal. However, it's happening s-l-o-w-l-y. But, so did putting it on, so I'm trying to be patient.

I just gotta throw this in.........my health improved when I questioned and learned and chose not to follow everything the doctor said - for example, not taking statins and ace inhibitors. They affected my well-being so much, I didn't have the energy to exercise. Without them, I was able to do more and improve my numbers. BUT.........that's a personal choice and has to be weighed carefully. I monitor both (blood pressure & cholesterol) very carefully.

Have a great time on Vay-K, Marty.

Cheri

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Permalink Reply by marty peters on November 10, 2009 at 9:05am

Hi Everyone,

Well, I did have a great time in San Antonio, TX...Now for my latest on Symlin and so on. The Symlin has greatly reduced my cravings between meals. I now go upwards of 16 hours without eating or an inclination to eat. That is an odd but welcomed feeling for me. I took the advice and started down the low carb approach. So far, I reduced my average carb intake from 160-180 a day to about 110.

The downside is my BGs were still on a roller-coaster. My endo changed my IC from 1;10 to 1:8 and now it's 1:5 which is where I was before Symlin. The retun to IC 1:5 is the best setting for me.

I am just baffled as to why as a Type II I need some much daily insulin even with reduced carb intake. I guess it just my body but it's disappointing. I avg about 75 units daily. When I mention this to Type 1 persons I get the reaction of "Wow!".

I did stop using Lipitor for the last 2 weeks to prove it was the cause of my muscle pains in my thighs, back and upper legs. It was....I think I am going to try a reduced amount and see what happens. Doc agrees with this. Maybe go to Crestor as an alternative.

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Permalink Reply by Cheri on November 10, 2009 at 1:06pm

Hi Marty - Good to hear from you. Glad you enjoyed San Antonio. Also glad to hear you got off the statin - it's awful stuff and we diabetics seem especially susceptible to the side effects. Again, as my A1c improved, so did my cholesterol numbers - without statins.

That's great that you're down to about 110 g carb a day. That's a good reduction. I'm at ~60 a day - but pretty much 0 in the mornings - I just can't tolerate them then. That's when my ratio is about 1:5 so it's just not worth it to me. So, I stick to protein/fat in the a.m. and eat my carbs at lunch or dinner. My I:C ratio at other times of the day is 1:10 or 1:12.

As far as symlin and the roller coaster - I have to say that I do have to watch more carefully. I've taken to setting my alarm to 90 minutes after eating. Any earlier and it's like wasting the insulin, but if I wait any longer to bolus, I will get quite a spike - higher than I used to get before Symlin, when I just bolused before eating. So I try to watch it. Other than that, I am happy with no appetite and I am happy to have reduced my insulin. I've gone from about 50 U of basal and 20 U of fast-acting to ~24 U basal and ~10 U fast-acting....so, from about 70 total to about 34 total. And it's cascading downward as I lose weight - 10 pounds so far!

If you are highly resistant, you may find the amount needed goes down as you lose weight. We T2s tend to be very insulin resistant and insulin is a fat-building hormone. The thing that keeps us alive also makes us sicker...........in that it becomes a vicious, spiraling cycle....more insulin, more weight, more insulin, more weight, and on and on. I really believe that one day the medical establishment will STOP telling T2s to go ahead and eat as many carbs as they want - just "shoot up" for it. It's crazy.

Take care. OH! Almost forgot my news - I'm going to go with the pump - the Animas Ping. I'm waiting to get the word.

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Permalink Reply by marty peters on November 10, 2009 at 11:25pm

Best of luck with your insulin pump. I decided to go with the Omnipod due to the 'no tubes' approach.

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