Bernard Farrell

I spoke with my pediatric endo today about my new diabetes community venture. First, I want to give a great big thank you and shout out to him. He is doing amazing things in the diabetes community. Thanks for being the best doc and putting up with me, Morey!

We talked about new treatment options that are coming into play. One of the ones we discussed is using the hormone amylin to control postprandial blood sugars. Amylin is a naturally occurring hormone produced by the beta cells (the ones that produce insulin). The body gives amylin with insulin when glucose is consumed. They have found that low levels of insulin are typically accompanied with low levels of amylin.

Symlin is the synthetic version, and the readily usable version, of amylin. Symlin is given prior to meals along with regular insulin boluses to create smoother postprandial levels. There are also the added affects of needing less insulin, possibly eating less, feeling fuller quicker and longer, and potential weight loss.

I've considered Symlin since I first learned about it (since right before I went on the pump). I haven't ever tracked my postprandial levels so I'm not quite sure if that's an issue for me. However, I want the best control that I can get.

Just tonight I tracked my postprandial levels (however, it was with a restaurant meal so probably inaccurate carb counting). One hour after the meal, I was 224. Two hours I was 195. So obviously, I could use less of a swing. I'm going to continue tracking post prandials at major meals for the next month. If after a month, I find that I'm rising above 180 (suggested postprandial level) two hours after a meal, I'll go on Symlin. If not, I'll continue managing the way I am.

My concerns with Symlin are that sometimes I have postprandial lows. This only started since I've been on the pump. I'm not sure exactly what causes it for me, whether it's inaccurate carb counting (I'm doubtful of that because I'm good at it) or delayed food absorption or incorrect use of square and dual wave boluses. Maybe in the next month, I'll try to figure out when and how to use those two boluses. I feel like I'm still not maximizing the pump entirely because those boluses confuse me as to when to use them.

The bonuses with Symlin would be the potential weight loss and the need for less insulin. I would love to be able to control my blood sugars more accurately so that I'm not peaking so much, obviously. But Symlin would also give me the weight control I'm looking for by cutting my insulin use and giving me some help for feeling fuller. I realize that I'm not heavy by any means (of course, most of you don't really know, now do you?), but I would like to be able to lose a few pounds that have been put on between the PCOS, hypothyroidism, and diabetes.

So, I guess I'm off on a Symlin quest. Will I need it? Will I want it? Will it even work?