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Time to Change

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This morning my Dexcom sensor refused to record any BG values despite numerous restarts. This took tremendous patience considering each restart took at least 2 hours.

Finally I decided I would go to the gym, and start over after my shower with the second trial sensor. Considering I started the first sensor on 2/13 I think I did pretty well (12 days). The new sensor went in much easier than the first one, but most of that pain came from the rep trying to make sure the transmitter was in tight.

Anyone curious what the Dexcom sensor looks like? Well, a little like this… 🙂

My intent from the beginning was to use the first sensor with my normal routine and my second with my (also free) trial of Symlin. I took the first dose tonight with dinner. My endo and I had discussed cutting my bolus by 1/3 or 1/2 to accommodate the Symlin effects. I took 3 units of Sylmin and did a 3.2 bolus instead of 4.8 (1/3 reduction). The results during the first 2-3 hours were fabulous.

Then I began steadily climbing… and climbing… and climbing… and correcting… and correcting. I can’t figure out if it is the Symlin or some other cause. I did read that using insulin syringes to inject the Symlin may cause problems because it is hard to inject small amounts of units with them. Maybe I did not get as much Symlin as I thought. The weird thing is that the climbing started about 3 hours after my meal.

Will probably try the Symlin again with breakfast and dinner tomorrow. I don’t think I want to deal with the hassle of it at work, so I think I will skip lunch.

Stay tuned.

Edited to add:
Thanks for your comments – they were really helpful.
I tried calling my endo’s office but she is out of town. I explained the situation to one of the nurses and she said she would look up my file (not sure why) and call me back. A little after 5 pm the diabetes educator from the office called me and left a voicemail. Apparently the nurse did not exactly understand the situation because the educator’s reccomendations were exactly what I was already doing.

The comment left by Laura G. sounded promising, so I am following her plan – giving myself the correction for my target and Symlin injection at mealtime and dual/square (can’t keep ’em straight) wave the rest over the next few hours. Right now it is 3 hours post meal and I am climbing a little (129 currently) but nothing like last night and breakfast this morning. A little more tinkering and I think I might stick with it until the sample vials are gone 🙂


5 responses

  1. I saw the same thing with Symlin, which is why I gave it up. Instead of jumping to 250 immediately after a meal, I was flat for 3 hours, then jumped to 400 — and corrections didn’t seem to work. So I was having higher spikes and taking more insulin on Symlin than wihtout. No thanks!

  2. Hi,

    I’ve been really pleased with Symlin–have used it for six months now. BUT, I had to do a lot of reading and experimenting to learn how to bolus with it. The 2-3 hr post meal climb you’re getting is normal for me unless I use an extended bolus. I’ve also had trouble with immediate lows when I give any insulin before the meal. Currently my routine is to inject symlin a few minutes before the meal, and if my BG is 110 or less, eat first (to prevent a big drop!), then give an extended bolus of 100% of the insulin for the meal (no reduction!) over 1 hr and 45 min. Then I’m pretty steady for 3-4 hours after the meal. If my BG is higher, then I give a correction and begin the same extended bolus before the meal. (That’s just what works for me, of course!) There’s a Symlin yahoo users’ forum and some postings on the Children with Diabetes list and the Insulin Pumpers list, and two useful articles in the DiaTribe newsletter ( I think.) Good luck!

  3. The delayed spikes happened with me as well. I was having to correct hours after the meal. Since I am on MDI, Symlin was just unworkable for me. I gave it about three months and gave up.

  4. This is a problem I had a lot with symlin, outside of the lows I consistently had. I would climb 2 to 3 hours out, as all that food was absorbing at this time. I used various types of boluses (combo, square, plain ol plain ol, delayed) and never got it quite right. I tried with the symlin almost a year before I gave it up. Good luck!

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