Hey everyone, I’m new to this forum but not diabetes. I’ve had type 1 now for 32 years. I am currently taking humalog through a pump , I wear a cgm and take the symlinpen in hopes for better numbers at mealtimes. My numbers aren’t terrible, i actually have a 6.5 A1C which I think is ok but I always strive for better. My question is has anyone taken or is now taking the symlin pen? I’m looking for recommendations on how to get it to work the best with timing and dosing. I haven’t really gotten that much help from calling the symlinpen number and I don’t think many people know to much about it.
Please let me know . I am currently taking 45 2x a day. One at breakfast and dinner. I workout after dinner so I hold off in fear that I’m going to plummet. I feel sometimes as soon as I take it I go low pretty quick but then go high just as quick like a hour or so later. I also couldn’t push the symlin pen down far enough to inject one or two times… It somehow was stuck. Has this happened to anyone before? Please let me know if anyone has any information on this.

@Alliedee1984 Hi Allison, and welcome to the JDRF TypeOneNation Forum!

No, I do not use the Symlin Pen. And, I’m not a licensed medical provider, so my response is just my thought based on living with diabetes and insulin for 64 years. To me, injecting Symlin while using an insulin infusion pump loaded with Humalog analog insulin is counterproductive, as well as, extremely dangerous. Each “benefit” gained from Symlin for a person living with Autoimmune [T1] Diabetes can be better achieved by proper programming and use of FDA Approved currently on the market. I don’t mean to sound harsh, just my experience.

In-Range pre-prandial glucose readings are usually best achieved through a combination of basal rate settings [lower = better] combined with effective carb:insulin ratio for prior meal; post-prandial BGL [Body Glucose Level displayed by your CGM] readings are achieved by I:C Ratio based in relatively accurate carb counting plus/minus correction calculated with you ISF [Insulin Sensitivity Factor] for the time of day; if needed for your particular situation, the meal time bolus can be infused with your pump either at beginning of meal, during meal or, before meal.

The US FDA provides the following cautionary notice to prescribing physicians:

Symlin use with insulin increases the risk of severe hypoglycemia, particularly in patients with type 1 diabetes. When severe hypoglycemia occurs, it is seen within 3 hours following a Symlin injection. Serious injuries may occur if severe hypoglycemia occurs while operating a motor vehicle, heavy machinery, or while engaging in other high-risk activities. Appropriate patient selection, careful patient instruction, and insulin dose reduction are critical elements for reducing this risk.

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I’m not familiar with Simlyn but have been using a pump for many years. The pump should be programmed to deliver sufficient basal insulin to keep numbers in range, and a carb ratio to cover the foods you eat. Injecting on top of insulin delivered via pump can be dangerous, especially if you are taking that much twice a day. If Symlin + pump is a new protocol I’m not familiar with it. We are encouraged to be our own doctor but I wonder if this was put in place by your physician? If you need additional insulin to achieve the control you want I would recommend you speak with your endo about adjusting your pump settings - I’ve found small changes of 0.1 unit or even less have made a big difference for me. Perhaps working with your doctor to change some settings will get you where you want without the danger of yet more insulin or other injectable.
Adding later
I’m not a physician, and in my comment above I expressed concern about the amount of Symlin you take, thinking it was an insulin product. I had done a little (very little) looking online before I wrote them, but with further reading I see what you’re taking is one of the recommended doses: so forgive me for speaking out of turn on that. However Symlin does come with cautions about the risks of going low and again I would advise you to discuss that medication and alternatives for getting the tighter control you desire, especially since you are using a pump.
I grew up with diabetes before “tight control” - you did the best you could to keep sugar from spilling into your urine at least too much (I’m ancient and grateful to be). When tight control first became “a thing” I heard stories about people going so low they lost consciousness while trying to achieve it. Thankfully‼️ now we have CGMS to help, but they’re not perfect. 6.5 is the “introductory number” for diabetes according to what I pulled from the ADA Understanding A1C | ADA. So as see I it in my personal, non-medical opinion, it’s not bad. You have diabetes and your desire to get your number into the range for those who do not have it, is admirable but be careful in how you get there; and if your numbers tend to run very close to 100 - consider allowing yourself some cushion for error or unexpected events. But most of all discuss with your doctor the goal that is safe for you in terms of target BG and A1C.

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Thank you for your response. I am aware that it causes low blood sugars. My endo has significantly decreased my icr to prevent those lows. I wanted to try the symlin to cut back on the amount of insulin I take. If I go off of it I will most likely double the insulin amount which I do not want to do.