Symlin Stuff (part 1)

Based on the comments I’ve received on using Symlin, there are a lot of questions and interest in it.  I’ll post a bit about it periodically, just hoping to keep the posts somewhat short and digestible.

I’ve done a few posts on Symlin already, and I’ll round them up here so you can take a peek at them if you wish.

Does that have something to do with it?
A New Variable and Mixed Feelings
Symlin So Far

It feels like THE MISSING LINK
Pumping Symlin (part 1)
It seems almost magical
Pumping Symlin (part 2)
Pumping Symlin (part 3)
Pumping Symlin (part 4)

Those links cover most of the posts where Symlin played the starring role.  There have also been a handful of others where it played a contributing part.

Here’s a very quick and basic rundown of my understanding of Symlin.  It slows digestion (therefore slowing down carbs effect on blood sugar), sends a subtle signal to the brain that you are satiated (you feel full with less food), and turns off the release of glucose from the liver (because there is food present).

Before my next post on Symlin, I’d like you to think about how those things might be helpful for you and your blood sugar management, and how those things might be bad for you and your blood sugar management.

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9 thoughts on “Symlin Stuff (part 1)

  1. Hi Darlene – I’m not 100% sure. There is a similar drug called Byetta, which is used for type 2. From what I understand, it offers a lot of the same benefits.
    Bill – That’s frustrating. Maybe some of the folks in the forums here at Diabetes Daily can offer their thoughts? Or another great forum is over at TuDiabetes.org. Start a thread in either forum and see what sort of questions and/or ideas come up. We can’t offer any direct medical advice, but maybe some thoughts/ideas can help you get an idea of what’s going on.

  2. Well, I do not fell any difference in food cravings, and I am not overweight, 5’7″, 150 pounds, exercise forty minutes a day on NordicTrack and situps with no days off-my endo told me now to stop taking the Symlin in the AM since I was getting lows but I don’t think he understands the whole picture since the lows happen sometimes BEFORE the exercising and sometimes AFTER. ARGHHHH!!!

  3. I was put on Symlin back in May in addition to using a pump wiht Humalog. It seems to keep my suagr levels steadier but still my Ha1c has not really changed after being on it for three months. doctors don;t know what’s up and today my sugars didin;t go over 100 and I didin’t use any Symlin-it’s maddening and this is after being ont he pump for over six years now.

  4. A point of dispute with Jenny Sutherland’s comment: Technically speaking, Symlin (pramlitide acetate) is considered an analog of human amylin, which is a neuroendocrine hormone (not an enzyme) that is co-secreted with insulin from pancreatic beta cells which is completely absent in patients with type 1 diabetes mellitus. The hormone slows intestinal carbohydrate absorption through decreased gastric emptying and suppresses hepatic gluconeogenesis by inhibiting glucagon secretion postprandially. However, amylase an enzyme that breaks starch down into sugar. Amylase is present in human saliva, where it begins the chemical process of digestion. Although the pancreas also makes trace amounts amylase (alpha amylase) to break down dietary starch into di- and trisaccharides which are converted by other enzymes to glucose to supply the body with energy, I do not find any references in the clinical literature which suggest that alpha amylase is produced by the pancreatic beta cells.
    In response to your specific request, my question is as follows:
    The FDA instructed the manufacturer to warn of an increased risk of insulin-induced severe hypoglycemia. Amylin says that when severe hypoglycemia associated with Symlin use occurs, “its seen within three hours following a Symlin injection.” According to the FDA information on file for Symlin, in clinical trials, units of insulin taken fell about 20% for type 1 patients, to 35-40 units per day from 45-50 units, and to 70-75 units per day from 80-90 units per day for type 2 patients. Some doctors who are very experienced in using Symlin with their patients have actually found that by reducing the total daily dosage of insulin, instances of hypoglycemia are actually reduced using Symlin. Obviously, there is a learning curve involved, but I’m curious as to the impact on your total daily dosage (TDD) and whether using it has impacted your incidence of hypos (and if so, how?).

  5. My sister in law has had great success w/ symlin … since I seem to be stuck in the middle I was put on byetta first but it did not work well at all for me… the next step was to be trying symlin but I did not end up pursing it …
    Is there an actual test to check amylase?

  6. It’s a synthetic amylase usually deficient in type 1 diabetics. It’s worked for me, in regards to BG’s, but it can make you feel overly full. I never got badly nauseated, but felt like “URP!” after an egg salad sandwich and a small apple.
    I used it more on days off at first, in case it caused a problem at work… and now that I know how it acts, I use it for anything over 35g CHO.

  7. If your digestion is already slow, then this could potentially be bad, if it slowed digestion down even further . . . I guess more info is needed to be sure.