RE: Symlin, An Injectable Form of Amylin

[Guest guest]

So if I'm reading this right, Symlin is taken in conjunction with Humalog (or

fast acting insulin). Is this correct? IF so, I for one am not overly anxious to

try it. I take a minimum of 4 injections now, and really don't want to add 2 or

3 more. I think Symlin would be especially helpful to people who are really

struggling with blood sugar control though. From the sounds of it, for these

folks, this form of insulin may be just what they need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction. (Proverbs

16:23)

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was so

critical to survival. It was not until 1970 that amylin was discovered, and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type 1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl (2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2 to

6 units taken two or three times a day before meals are required to do this.

Symlin is usually taken just before meals that contain at least 250 calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A safer

way to increase Symlin is to start with 2 units before two or three meals a

day, or 1 unit if your TDD is less than 30 units of insulin a day. Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses, with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for more

than two or three days, do not restart with full doses. Instead, restart at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120. The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

Yes, you are right, it is taken with rapid-acting insulin, which would mean

you would have to take two injections before eating. However I have heard of

some people using it in a pump (in which case they would be wearing two

pumps). I think I've also heard that perhaps Lilly is working with Amylin

(the people who make Symlin and also Byetta) to make a device that would

deliver both insulin and amylin in one injection, though I may have just

imagined this. *smile*

If your after-meal blood sugars are within range and you are not having

problems with weight, then I think there's probably no need to fix what

isn't broken.

It's important to know that Symlin is not " another form " of insulin, though.

It cannot be taken instead of insulin but must be taken in conjunction with

it. Insulin and amylin are completely separate hormones that work together

to regulate blood sugar levels, just as insulin and glucagon are completely

separate hormones. It is still insulin which actually controls the blood

sugar, amylin just does some things that make that control easier after

meals.

Jen

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

Hi Jen,

Gottcha on the hormone thing, and that amylin or symlin are not insulin. I

agree. I'm probably not broken quite enough to warrant trying to fix things

with Symlin!

Dave

A wise man's heart guides his mouth, and his lips promote instruction. (Proverbs

16:23)

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

Dave,

Could you please contact me off list as your emails are bouncing. I have a lady

who wishers to subscribe to the list and is having a problem in doing so. Sorry

to place this on list. Regards, Margaret Macarthur.

Send<doves1@...

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

Dave,

Could you please contact me off list as your emails are bouncing. I have a lady

who wishers to subscribe to the list and is having a problem in doing so. Sorry

to place this on list. Regards, Margaret Macarthur.

Send<doves1@...

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

I found this very interesting, my husband had read some of it too me out of the

package but it is diffrent reading it here, one thing I thought of, is that,

the pens I have are in 15 units, 15 being the smallest each step you pull the

lever back it goes up another 15, up to 120 , any more then that you have to

take a second shot, My husband said that the unit's are a diffrent size then

insulin, so maybe that is why it explains it this way, thus 15=1 unit.... not

sure. maybe there is a diffrent sort of pen?

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was so

critical to survival. It was not until 1970 that amylin was discovered, and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type 1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl (2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2 to

6 units taken two or three times a day before meals are required to do this.

Symlin is usually taken just before meals that contain at least 250 calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A safer

way to increase Symlin is to start with 2 units before two or three meals a

day, or 1 unit if your TDD is less than 30 units of insulin a day. Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses, with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for more

than two or three days, do not restart with full doses. Instead, restart at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120. The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

I found this very interesting, my husband had read some of it too me out of the

package but it is diffrent reading it here, one thing I thought of, is that,

the pens I have are in 15 units, 15 being the smallest each step you pull the

lever back it goes up another 15, up to 120 , any more then that you have to

take a second shot, My husband said that the unit's are a diffrent size then

insulin, so maybe that is why it explains it this way, thus 15=1 unit.... not

sure. maybe there is a diffrent sort of pen?

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was so

critical to survival. It was not until 1970 that amylin was discovered, and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type 1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl (2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2 to

6 units taken two or three times a day before meals are required to do this.

Symlin is usually taken just before meals that contain at least 250 calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A safer

way to increase Symlin is to start with 2 units before two or three meals a

day, or 1 unit if your TDD is less than 30 units of insulin a day. Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses, with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for more

than two or three days, do not restart with full doses. Instead, restart at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120. The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

yes you would have to take at least three more shots a day, more if you are on a

higher level.

I am told that it also has to be taken closer to meal time then insulin, the

package said within ten mins of eatting

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was so

critical to survival. It was not until 1970 that amylin was discovered, and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type 1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl (2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2 to

6 units taken two or three times a day before meals are required to do this.

Symlin is usually taken just before meals that contain at least 250 calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A safer

way to increase Symlin is to start with 2 units before two or three meals a

day, or 1 unit if your TDD is less than 30 units of insulin a day. Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses, with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for more

than two or three days, do not restart with full doses. Instead, restart at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120. The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

yes you would have to take at least three more shots a day, more if you are on a

higher level.

I am told that it also has to be taken closer to meal time then insulin, the

package said within ten mins of eatting

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was so

critical to survival. It was not until 1970 that amylin was discovered, and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type 1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl (2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2 to

6 units taken two or three times a day before meals are required to do this.

Symlin is usually taken just before meals that contain at least 250 calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A safer

way to increase Symlin is to start with 2 units before two or three meals a

day, or 1 unit if your TDD is less than 30 units of insulin a day. Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses, with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for more

than two or three days, do not restart with full doses. Instead, restart at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120. The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

and you do not have to be on insulin to take it, however as I mentioned before I

have some concerns about this, but from what my doctor has said and what I have

read today, many people do it.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

and you do not have to be on insulin to take it, however as I mentioned before I

have some concerns about this, but from what my doctor has said and what I have

read today, many people do it.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

sorry just adding in my two cents, that was what I told my doctor today, is why

fix what is not broke, but her point with me is the less insulin a person can be

on the better. I would think that is the same for type 1's too.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

sorry just adding in my two cents, that was what I told my doctor today, is why

fix what is not broke, but her point with me is the less insulin a person can be

on the better. I would think that is the same for type 1's too.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

I think the pens come in 15 mcg increments. Apparently 15 mcg is equal to

2.5 units on an insulin syringe (insulin is the only medication that uses

standard " units " , most others are measured in mg or mcg, such as glucagons

which comes in a 1 mg dose). So 15 mcg is 2.5 units, 30 mcg is 5 units, 120

mcg is 10 units and the maximum dose.

Jen

Re: Symlin, An Injectable Form of Amylin

I found this very interesting, my husband had read some of it too me out of

the package but it is diffrent reading it here, one thing I thought of, is

that, the pens I have are in 15 units, 15 being the smallest each step you

pull the lever back it goes up another 15, up to 120 , any more then that

you have to take a second shot, My husband said that the unit's are a

diffrent size then insulin, so maybe that is why it explains it this way,

thus 15=1 unit.... not sure. maybe there is a diffrent sort of pen?

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know

that people call me a feminist whenever I express sentiments that

differentiate me from a doormat or a prostitute. " -- West

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over

time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released

at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was

so

critical to survival. It was not until 1970 that amylin was discovered,

and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation

by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type

1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we

recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise

the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl

(2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the

normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal

readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2

to

6 units taken two or three times a day before meals are required to do

this.

Symlin is usually taken just before meals that contain at least 250

calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each

meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A

safer

way to increase Symlin is to start with 2 units before two or three meals

a

day, or 1 unit if your TDD is less than 30 units of insulin a day.

Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses,

with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you

inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended

bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for

more

than two or three days, do not restart with full doses. Instead, restart

at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss

drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to

have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh

bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose

will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin

made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120.

The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

I think the pens come in 15 mcg increments. Apparently 15 mcg is equal to

2.5 units on an insulin syringe (insulin is the only medication that uses

standard " units " , most others are measured in mg or mcg, such as glucagons

which comes in a 1 mg dose). So 15 mcg is 2.5 units, 30 mcg is 5 units, 120

mcg is 10 units and the maximum dose.

Jen

Re: Symlin, An Injectable Form of Amylin

I found this very interesting, my husband had read some of it too me out of

the package but it is diffrent reading it here, one thing I thought of, is

that, the pens I have are in 15 units, 15 being the smallest each step you

pull the lever back it goes up another 15, up to 120 , any more then that

you have to take a second shot, My husband said that the unit's are a

diffrent size then insulin, so maybe that is why it explains it this way,

thus 15=1 unit.... not sure. maybe there is a diffrent sort of pen?

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know

that people call me a feminist whenever I express sentiments that

differentiate me from a doormat or a prostitute. " -- West

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over

time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released

at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was

so

critical to survival. It was not until 1970 that amylin was discovered,

and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation

by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type

1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we

recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise

the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl

(2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the

normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal

readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2

to

6 units taken two or three times a day before meals are required to do

this.

Symlin is usually taken just before meals that contain at least 250

calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each

meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A

safer

way to increase Symlin is to start with 2 units before two or three meals

a

day, or 1 unit if your TDD is less than 30 units of insulin a day.

Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses,

with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you

inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended

bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for

more

than two or three days, do not restart with full doses. Instead, restart

at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss

drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to

have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh

bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose

will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin

made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120.

The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

She wants me in the end on 180, so I will take a shot of the 120 pen and off the

60 pen.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over

time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released

at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was

so

critical to survival. It was not until 1970 that amylin was discovered,

and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation

by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type

1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we

recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise

the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl

(2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the

normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal

readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2

to

6 units taken two or three times a day before meals are required to do

this.

Symlin is usually taken just before meals that contain at least 250

calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each

meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A

safer

way to increase Symlin is to start with 2 units before two or three meals

a

day, or 1 unit if your TDD is less than 30 units of insulin a day.

Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses,

with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you

inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended

bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for

more

than two or three days, do not restart with full doses. Instead, restart

at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss

drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to

have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh

bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose

will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin

made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120.

The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

She wants me in the end on 180, so I will take a shot of the 120 pen and off the

60 pen.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over

time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released

at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was

so

critical to survival. It was not until 1970 that amylin was discovered,

and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation

by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type

1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we

recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise

the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl

(2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the

normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal

readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2

to

6 units taken two or three times a day before meals are required to do

this.

Symlin is usually taken just before meals that contain at least 250

calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each

meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A

safer

way to increase Symlin is to start with 2 units before two or three meals

a

day, or 1 unit if your TDD is less than 30 units of insulin a day.

Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses,

with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you

inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended

bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for

more

than two or three days, do not restart with full doses. Instead, restart

at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss

drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to

have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh

bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose

will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin

made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120.

The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

Hey Jen, I know you are putting all this info for the entire list, but I just

want to say thank you.

I called her this eve, and had a long talk about all this.

I do not want a roller coaster to happen, so she and I agreed to step down my

long term, as I step up the symlin, so that I do not end up all out of whack.

She is willing to listen to me, when I can present my reasons, I think that is a

good point in her direction, and your information has helped me do that.

My bloodshugars are staying between 100 and 150 right now and I really just do

not want to mess it up, I work too hard to get the control I have.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over

time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released

at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was

so

critical to survival. It was not until 1970 that amylin was discovered,

and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation

by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type

1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we

recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise

the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl

(2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the

normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal

readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2

to

6 units taken two or three times a day before meals are required to do

this.

Symlin is usually taken just before meals that contain at least 250

calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each

meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A

safer

way to increase Symlin is to start with 2 units before two or three meals

a

day, or 1 unit if your TDD is less than 30 units of insulin a day.

Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses,

with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you

inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended

bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for

more

than two or three days, do not restart with full doses. Instead, restart

at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss

drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to

have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh

bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose

will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin

made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120.

The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

Hey Jen, I know you are putting all this info for the entire list, but I just

want to say thank you.

I called her this eve, and had a long talk about all this.

I do not want a roller coaster to happen, so she and I agreed to step down my

long term, as I step up the symlin, so that I do not end up all out of whack.

She is willing to listen to me, when I can present my reasons, I think that is a

good point in her direction, and your information has helped me do that.

My bloodshugars are staying between 100 and 150 right now and I really just do

not want to mess it up, I work too hard to get the control I have.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Symlin, An Injectable Form of Amylin

Symlin, An Injectable Form of Amylin

Used to Improve Post Meal Glucose Control (Type 1)

and Weight Loss (Type 1 and possibly Type 2)

During the destruction of beta cells in Type 1 or Type 1.5 diabetes by

friendly fire from antibodies, the body actually loses two hormones. And

similar to insulin, Amylin production may fall in Type 2 diabetes over

time.

Amylin is normally co-secreted alongside insulin and, like insulin, is

released by the beta cells around the clock with larger amounts released

at

mealtimes.

Insulin was the first of the two hormones to be discovered because it was

so

critical to survival. It was not until 1970 that amylin was discovered,

and

not until the early 1990s is that its role began to be understood. Not

essential for life, amylin plays an important role in glucose regulation

by

slowing digestion and suppressing an excessive release of glucagon that is

seen after meals in Type 1 diabetes. The excess glucagon rise seen in Type

1

diabetes causes additional glucose release by the liver at mealtimes. The

release of amylin at mealtimes minimizes the glucose spikes that are often

seen in Type 1 diabetes after meals.

Symlin is a modified longer-acting form of amylin that was released by the

FDA in 2005. This prescription medication dramatically improves post meal

glucose control and reduces glucose variability and glucose exposure in

anyone whose insulin production is limited. Symlin decreases glucagon

secretion, decreases appetite, and delays gastric emptying. When injected

before meals, post meal blood sugars become easier to control. Users often

comment that they feel better with more stable glucose readings.

One caution when starting on Symlin is that it can cause severe low blood

sugars if meal insulin doses are not lowered on the day it is started and

for at least the first few days of use. If meal insulin doses are not

reduced, up to 30% of users experience severe hypoglycemia within about 3

hours of eating. To reduce the risk of hypoglycemia, Symlin is started at

very small doses and then gradually increased every few days until the

desired effect is seen. Meal insulin doses are typically reduced by 30% to

50% when starting and later adjusted based on pre and post meal glucose

results once a final Symlin dose is reached. Long-acting insulin doses or

basal rates may also need to be lowered, especially if these make up more

then 50% of the starting TDD (total daily dose of insulin). As weight loss

occurs in someone who is overweight, additional insulin reductions will be

needed over time.

Dosing

Symlin is injected with a standard insulin syringe, so dosing is flexible.

How much to use depends on what it is used for. For weight loss, maximum

doses are usually best, while lower doses often work when the goal is to

normalize post-meal glucose levels. The manufacturer recommends starting

with 2.5 units and increasing to 5 units, then 7.5 units, and 10 units

before each meal if no nausea is encountered for three days.

However, different people will require very different doses and we

recommend

that Symlin doses be individualized in the same way as insulin doses. If

your goal is to reduce post meal spiking and glucose variability, raise

the

Symlin dose by one unit every three days until you reach a dose where most

of your post meal blood sugar readings rise no more than 40 to 60 mg/dl

(2.2

to 3.3 mmol) above where they started. The idea is to take enough to have

good post meal control (less variability) without overly delaying the

normal

rise in glucose after a meal (less problem correcting a low reading). Keep

raising the Symlin or increasing meal boluses until post meal readings are

consistently less than 60 mg/dl (3.3 mmol) higher than the premeal

readings.

The correct doses of Symlin and insulin allow you to keep most post meal

readings from rising much while causing few lows. In many Type 1s, only 2

to

6 units taken two or three times a day before meals are required to do

this.

Symlin is usually taken just before meals that contain at least 250

calories

or 30 grams of carbohydrate. If a dose is missed, wait until the next meal

to take the regular scheduled dose.

Your current TDD for insulin can guide your premeal Symlin dose.

Approximately 10% of your insulin TDD is needed as Symlin before each

meal.

For instance, if you use 40 units of insulin a day you will need

approximately 4 units of Symlin before each meal to control your post meal

readings. For weight loss, of course, larger amounts will be needed. A

safer

way to increase Symlin is to start with 2 units before two or three meals

a

day, or 1 unit if your TDD is less than 30 units of insulin a day.

Increase

by 1 unit per meal every three days as long as nausea is not present.

Post meal Control

Glucose spiking after meals can be totally eliminated at higher doses,

with

flat glucose trend lines often seen on a continuous monitor. At higher

Symlin doses, however, if a large carb meal is consumed, the rise in the

blood sugar may not be seen until several hours later, such as a high

reading at breakfast the next morning after a large carb intake at dinner.

Matching injected insulin doses to Symlin can be difficult. Today's rapid

insulins become too fast when larger doses of Symlin are used. If you

inject

your insulin, the use of a slower insulin like Regular may be preferred.

On a pump, a combo bolus (some now, the rest over time) or an extended

bolus

can be used to match the slower rise in glucose after meals. If a blood

sugar is low before a meal, raise it before taking Symlin. Reduce the meal

bolus and give it as an extended bolus. If Symlin doses are missed for

more

than two or three days, do not restart with full doses. Instead, restart

at

a lower dose and build up to lessen the risk of hypoglycemia.

Weight Loss

Less hunger allows some people who are overweight to lose significant

amounts of weight, while normal weight individuals lose none. Symlin is

currently undergoing studies for approval by the FDA as a weight loss

drug.

For weight loss, the dose may occasionally need to go higher.

Stability

Symlin is less stable than insulin. If one bottle of Symlin appears to

have

no effect on your blood sugar try another bottle. Symlin activity is more

vulnerable to time and temperature than insulin and can lose significant

activity, especially if a sample bottle was handed out from a physician's

office. If you seem to get little effect from a bottle, start a fresh

bottle

at a lower dose. Excess doses are easy to spot by a feeling of fullness or

nausea after the dose is given. Vomiting and diarrhea may occur on an

excessive dose. If side effects occur, simply lower the dose by one or 2

units. Increase the dose again after there is no fullness or nausea for at

least three days.

Tips On Handling Lows

Symlin delays the digestion of all food, including the carbs you use to

raise a low blood sugar. If a low occurs, use glucose tablets if available

and chew them as long as possible to allow more glucose to be absorbed

directly into the bloodstream. Be patient, as the rise in your glucose

will

be slowed because of Symlin. Likewise when lowering a high reading with

insulin, it will take longer and may require larger than normal insulin

doses because food is still being absorbed.

The Symlin Pens

The FDA approved pre-filled Symlin pens in November of 2007 and Amylin

made

them available in January of 2008. Previously, it was only available in

vials. There are currently two pens available: the SymlinPen 60 and 120.

The

SymlinPen 60 delivers 15, 30, 45, or 60 micrograms per dose. The SymlinPen

120 delivers 60 or 120 micrograms per dose. Both may be stored at room

temperature, up to 86 degrees, after first use.

Summary

Even though Symlin affects the blood sugar, it does not control it. Your

carb boluses and basal rates must still be adjusted to match the carb

amounts and types that you eat. Once an effective dose of Symlin is found,

adjust your insulin doses or boluses and basal rates as needed and be

prepared to readjust periodically if you are also losing weight.

Learn more about Symlin at their website, www.symlin.com.

[Guest guest]

Hi Kelleigh,

Type 1s do not produce any insulin so we cannot ever get off insulin. If a

type 1 didn't take insulin they would get into quick trouble with

ketoacidosis and fall into a coma within a few days and die shortly

thereafter. This is why it used to be called " insulin dependent " diabetes.

Most type 2s, even those who take insulin, are not truly insulin dependent

in that they will not be in a life-threatening situation if their insulin

was taken away, even if their blood sugars might be uncontrolled without it.

So while I do agree that if someone is taking loads of insulin to cover tons

of junk food it's not good (in the same way that it's not good for a

non-diabetic to make their body pump out tons of insulin to cover junk), I

don't really agree that less is necessarily better for a type 1. Each person

is individual and for a type 1 they might need 20 units a day or might need

50 a day, but whatever they need is what they need and as long as they

aren't gaining weight or having problems with low blood sugars, I don't

think cutting back would be of much benefit.

However for type 2s if they can get off insulin and maintain good control I

say go for it. Fewer injections and almost no risk of hypoglycemia would

sound good to me!

Jen

Re: Symlin, An Injectable Form of Amylin

sorry just adding in my two cents, that was what I told my doctor today, is

why fix what is not broke, but her point with me is the less insulin a

person can be on the better. I would think that is the same for type 1's

too.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know

that people call me a feminist whenever I express sentiments that

differentiate me from a doormat or a prostitute. " -- West

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

Hi Kelleigh,

Type 1s do not produce any insulin so we cannot ever get off insulin. If a

type 1 didn't take insulin they would get into quick trouble with

ketoacidosis and fall into a coma within a few days and die shortly

thereafter. This is why it used to be called " insulin dependent " diabetes.

Most type 2s, even those who take insulin, are not truly insulin dependent

in that they will not be in a life-threatening situation if their insulin

was taken away, even if their blood sugars might be uncontrolled without it.

So while I do agree that if someone is taking loads of insulin to cover tons

of junk food it's not good (in the same way that it's not good for a

non-diabetic to make their body pump out tons of insulin to cover junk), I

don't really agree that less is necessarily better for a type 1. Each person

is individual and for a type 1 they might need 20 units a day or might need

50 a day, but whatever they need is what they need and as long as they

aren't gaining weight or having problems with low blood sugars, I don't

think cutting back would be of much benefit.

However for type 2s if they can get off insulin and maintain good control I

say go for it. Fewer injections and almost no risk of hypoglycemia would

sound good to me!

Jen

Re: Symlin, An Injectable Form of Amylin

sorry just adding in my two cents, that was what I told my doctor today, is

why fix what is not broke, but her point with me is the less insulin a

person can be on the better. I would think that is the same for type 1's

too.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know

that people call me a feminist whenever I express sentiments that

differentiate me from a doormat or a prostitute. " -- West

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

Hi Kelleigh,

You are welcome for the information, I'm glad it's helped!

I think it's definitely a smart idea to transition over slowly rather than

all at once, to see how things unfold.

Good luck with it and let us know how your blood sugars are if you stop the

long-acting completely. Are you in the 100-150 range even after eating?

Jen

Re: Symlin, An Injectable Form of Amylin

Hey Jen, I know you are putting all this info for the entire list, but I

just want to say thank you.

I called her this eve, and had a long talk about all this.

I do not want a roller coaster to happen, so she and I agreed to step down

my long term, as I step up the symlin, so that I do not end up all out of

whack. She is willing to listen to me, when I can present my reasons, I

think that is a good point in her direction, and your information has helped

me do that.

My bloodshugars are staying between 100 and 150 right now and I really just

do not want to mess it up, I work too hard to get the control I have.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know

that people call me a feminist whenever I express sentiments that

differentiate me from a doormat or a prostitute. " -- West

[Guest guest]

yep, I understand that, but is less insulin even better for type 1's, I mean

would it not be better to only have to take 10 units instad of 20.

I know that a type 1 can never be free of insulin.

sorry just asking so that I learn too.

are there not type 2's that are fully reliant on insulin because their pan is no

longer functioning at all, because of the long term damage.

I do not remember what test it was, but I know that she told me that it showed

that my pan was not fully at full function.

can type 2's become type 1?

I ask all this, because I really want to do all I can to keep things at bay.

When she put me on insulin, I thought that meant I would never come off of it

again, but here I am four years later...

I also fear how hard it is on my body to go on and off the insulin.

I have learned that, no matter if I am on insulin or not, my diet for the rest

of my life will have to be very strick and watched.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Re: Symlin, An Injectable Form of Amylin

So if I'm reading this right, Symlin is taken in conjunction with Humalog

(or fast acting insulin). Is this correct? IF so, I for one am not overly

anxious to try it. I take a minimum of 4 injections now, and really don't

want to add 2 or 3 more. I think Symlin would be especially helpful to

people who are really struggling with blood sugar control though. From the

sounds of it, for these folks, this form of insulin may be just what they

need.

Thanks very much Jen for the very informative article.

Dave

A wise man's heart guides his mouth, and his lips promote instruction.

(Proverbs 16:23)

[Guest guest]

yep, I have been watching it, even checking one aan hour after eatting just to

see if it was going up and then back down before my 2.5 hour check. An example

today I was 117, at breakfast, 1 hour later I was 126, and 2.5 hours later I was

132. I ate oatmeal, rassberries, butter, honey and milk, with a dash of cinimon.

the 117 was my wake up bs, and I was 107 at bedtime the night before.

I have only been doing the symlin for a few days, started it thursday.

but prior to it, I almost allways woke up at about 140 to 160.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know that

people call me a feminist whenever I express sentiments that differentiate me

from a doormat or a prostitute. " -- West

Re: Symlin, An Injectable Form of Amylin

Hey Jen, I know you are putting all this info for the entire list, but I

just want to say thank you.

I called her this eve, and had a long talk about all this.

I do not want a roller coaster to happen, so she and I agreed to step down

my long term, as I step up the symlin, so that I do not end up all out of

whack. She is willing to listen to me, when I can present my reasons, I

think that is a good point in her direction, and your information has helped

me do that.

My bloodshugars are staying between 100 and 150 right now and I really just

do not want to mess it up, I work too hard to get the control I have.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know

that people call me a feminist whenever I express sentiments that

differentiate me from a doormat or a prostitute. " -- West

[Guest guest]

I am not sure whether less insulin would be better for a type 1, assuming

their weight is stable and blood sugars are well controlled. I'm not sure

insulin itself has any harmful effects on the body. That's an interesting

question.

A type 2 can't become a type 1. Type 1 is caused by an autoimmune attack on

the pancreas, where the body's own immune system attacks and destroys the

insulin-producing cells. Type 2 is caused by insulin resistance *and* the

pancreas not making enough insulin to overcome this insulin resistance.

A type 2 can sometimes become totally insulin dependent and rely on it for

survival in the same way a type 1 does. This doesn't make them a type 1,

though, as their diabetes is still caused by insulin resistance and

resulting damage rather than an autoimmune attack. The term " insulin

dependent " however is vastly overused by many type 2s who are not truly

insulin dependent, but are just insulin treated.

A c-peptide test can tell how much insulin your pancreas is making. In the

early stages of type 2 diabetes a c-peptide test may show that the pancreas

is actually making more insulin than it should be in an attempt to overcome

the insulin resistance. In someone who has had type 2 for a long time it may

show that their pancreas is producing less insulin than it should, or

sometimes (though I personally think this is fairly rare) none at all. In

type 1 diabetes the test will initially show little or no insulin

production, and later on for most people it shows that the pancreas is

producing no insulin. They have found however that a small percentage (I

think 15%) of type 1s do retain a very small amount of insulin production

even after years of diabetes, just not enough for survival.

Jen

Re: Symlin, An Injectable Form of Amylin

yep, I understand that, but is less insulin even better for type 1's, I mean

would it not be better to only have to take 10 units instad of 20.

I know that a type 1 can never be free of insulin.

sorry just asking so that I learn too.

are there not type 2's that are fully reliant on insulin because their pan

is no longer functioning at all, because of the long term damage.

I do not remember what test it was, but I know that she told me that it

showed that my pan was not fully at full function.

can type 2's become type 1?

I ask all this, because I really want to do all I can to keep things at

bay.

When she put me on insulin, I thought that meant I would never come off of

it again, but here I am four years later...

I also fear how hard it is on my body to go on and off the insulin.

I have learned that, no matter if I am on insulin or not, my diet for the

rest of my life will have to be very strick and watched.

Kell

MSN: Kell@...

Skype: KlarssonNY

" I have never been able to find out precisely what feminism is: I only know

that people call me a feminist whenever I express sentiments that

differentiate me from a doormat or a prostitute. " -- West