I'm taking 120 mcg with the pen. (I actually think they discontinued the vials). I believe the spike from Symlin can be as late as 3 1/2 or 4 hours as it slows digestion. I test my blood sugar and bolus my insulin at the one hour mark but test at the 4 hour mark now, rather than the 2 hour when I spiked before. My numbers are in target range about the same percentage as they were before Symlin, but I am only taking 1/2 the insulin for breakfast and lunch and 60% at dinner.
I take my symlin right before eating, and sometimes up to 15 minutes or so before eating (if I am higher when testing.) I usually bolus right after eating and square wave my bolus for 2 hours. This usually keeps me in a good target range...usually.
I have the minimed pump, and always have, so I don't know the exact capabilities or terminology for the animas pump, but a square wave bolus is a bolus that is spread out over a user-set amount of time to be dispersed so that is not given all at once. I used to square wave my bolus starting an hour after eating, but it seems to work this way now, starting the bolus just after eating and spreading it out for two hours. If I end up not taking my symlin for whatever reason, I do a normal bolus. And sometimes with pizza, I square wave my bolus for three hours. I cannot comment the exact results for that because I have not had pizza often enough to see a pattern, but I usually do not spike after eating pizza!
Wow! That's very cool... I had Mexican today for lunch and did a combo bolus (same as your square wave), for three hours and still spiked... Are you bolusing for half the carbs doing it that way too? My diabetes educator said that she waits 30 minutes after she eats then bolus' and gives herself about 20 carbs as a freebee while she is on the Symlin. I tried 120 mcg for the first time today... I felt a bit naseated but it subsided quickly. My endo told me not to push it and to stick with 60 if 120 was too difficult on me.
Kelly, you will be pleased to know I have discovered the method that works for me... I didn't spike at all yesterday! Basically, I waited 30 to 60 minutes after eating and then bolused for 20 carbs less and BINGO! It worked! No spike! Now I am truly hooked... Just need to remember to shoot up now... LOL
That's great, Kaayle! I am doing pretty good without spiking. It seems lately I go too low, and when I spike, is when I over-correct. Sometimes my correction works, and sometimes I spike. I am so looking forward to my CDE appointment on Monday. I am meeting with Gary Scheiner, the author of Think Like A Pancreas. I am hoping to learn lots more and to work out the kinks. Another thing that is helping me with my sugars is Weight Watchers. For some odd reason I have not lost weight, but my blood sugars are so much better.
Kelly, do you know what level they are going to move you to? I am not sure if my doctor will be moving mine up to 120 mcg or keep me at 60 mcg. But I also have been on this for a few months now and am just now able to get my schedule lined up with my endo to follow up on the Symlin. Do you have a follow up after a few weeks at 60 mcg?
I have been on 45 mcg for about 2 months now. My endo didn't want me to go up to 60 yet till I was able to give her more detailed reports. I am going to see my cde on Monday; I am sure that he will be able to answer my questions and give me much more guidance regarding the symlin and dosing, timing, food types, and all that! I will let you know what he has to say!
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