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I've been using Symli
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The Question

07/01/06 10:39 PM

"I've been using Symlin about 2 months now and can't see a definite improvement. Are people having success with better control with Symlin and weight loss, because it's suppose to control your appetite. Nancy"
Asked By: nanner  
Category: Oral Medications

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Expert Answers (1)

07/01/06 10:39 PM

First, a quick review for our readers about how Symlin works. Symlin (pramlintide) is a injected synthetic replacement for the natural pancreas hormone amylin. Amylin is presumably deficient in all people with type 1 diabetes, and in some people with type 2, namely those who require mealtime insulin for their ongoing therapy. In type 2 diabetes, the body cells are also resistant to amylin, so more amylin is needed to do the job, which is three-fold: (1) reduce the amount of glucose released by the liver into the blood; (2) induce a feeling of fullness after meals; and (3) slow down how quickly the stomach empties its contents into the small intestine.

Has your dose been advanced since starting on Symlin? If not, inadequate dosing may be an issue in your case. The starting dose for those with type 1 is 15 micrograms (mcg) before meals, advancing up to 60 mcg every 3 to 7 days, in 15 mcg increments. The starting dose for those with type 2 is 60 mcg before meals, advancing every 3 to 7 days, until a dose of 120 mcg is reached. In both type 1 and type 2, mealtime insulin dosage is reduced by 50%, and adjusted as needed as time goes on.

The manufacturers of Symlin recommend that all patients have the ongoing support of a diabetes educator to help with fine-tuning their self-management with this form of therapy. I would advise you to discuss your concerns with your physician, ask about your dose requirements, and seek the help of a certified diabetes educator who is familiar with Symlin therapy. You can locate an educator near you by calling 1-800-TEAMUP-4.

Virginia Zamudio, RN, MSN, CDE

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