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New Ways to Administer Symlin
I noticed a lot of chatter of late on diabetes forum sites about Symlin use. Some are still on the fence about trying this synthetic form of the human hormone Amylin, normally made by the beta cells, which helps level out post-meal glucose peaks. Others are just grateful that it’s now available in a convenient injection pen.
In early June, Amylin reported results of a study using Symlin with 112 patients with Type 2 diabetes, which rather surprised me, as I originally thought this drug was aimed at Type 1s only. Checking the company’s website, I see that they now list Type 2 as their first target audience. Economically, this makes a lot of sense. But according to this article, Symlin remains appropriate only for patients who are already taking insulin. The balancing act between Symlin doses and insulin doses is a delicate one. And it’s none-too-convenient carrying all that gear around, either.
So what if you could administer Symlin using a patch pump like the one being developed by Valeritas? I heard a rumor that this is under consideration. The way I see it, there are some significant pros and cons:
PRO
* small, disposable device you wear for 24 hours at a time
* as easy to apply as a Band-AID, they say (no cannula, uses microneedles)
* no syringes or injection pen supplies to carry around
* a “no-brainer” as all you do is push a button when you’re ready to dose
CON
* wearing something stuck to your body all the time (still an issue for many people)
* you still have to fill it and stick it on every single day
* is it possible to push the dosing button by accident? Somehow that worries me
* disposable unit doesn’t seem too green
What do you all think? Would you be enthusiastic about Symlin in a small, disposable patch pump?
btw, if you’re wondering why I’ve never discussed trying Symlin, it’s simple: it took me years to achieve a settled stomach, so I’m not up for anything that might mess with gastric emptying. That said, never say never. If I ever got desperate to lower my postprandials, I might just hop the Symlin train after all.
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I can’t use symlin as I have gastroparesis, but theoretically, I’d be way more likely to try it that way than 3 shots a day.
Posted by: Christine | July 21st, 2008 at 6:30 amif this thing can work with micro-needles and no cannula, why can’t our insulin pumps!?
Posted by: chris | July 21st, 2008 at 7:16 amAn interesting idea. But, I’m still waitnig for symlin (in any form) to be available in Canada.
Posted by: Aaron | July 21st, 2008 at 7:45 amSymlin works great for me but I use it mostly for breakfast. It’s been the only thing that has ever allowed sane, reasonably flat morning postprandials. I use it for some other meals as needed depending on carb count and activity level, but mostly for breakfast. (BTW, Symlin has never created nausea or stomach disturbance for me, just an appropriate “full, stop eating” signal.) I’m glad it’s available in a pen now since I use so little each day–it lasts longer that way and I don’t waste half a vial.
I’d never consider using that patch pump for it–seems wasteful and expensive, and I wouldn’t want something else stuck to me, staying in my skin damaging my tissue and bugging me.
Posted by: Laura G. | July 21st, 2008 at 7:47 amI still suffer some PTSD from using symlin. I’m half-kidding, but it took me a long time to get over my fear that I would continue to have untreatable low blood sugar. It was not worth it for me. I guess everyone has a different experience w/it.
Posted by: Anne | July 21st, 2008 at 8:28 amI found Symlin to be a great tool for me (like anything else with diabetes, it is very individual), but really struggled with injections.
I experimented a little bit and have settled (for now) on a second pump. It creates some challenges (supplies, etc), but has allowed me to be more consistent with this new tool.
Posted by: Scott K. Johnson | July 21st, 2008 at 8:56 amHey, your favorite Type 2 diabetic on an insulin pump blogger has been on Symlin since it came out.
Works pretty well, but yeah, more stuff to carry. I would be interested in the micropump.
Posted by: Kathleen Weaver | July 21st, 2008 at 12:41 pmi am not a huge fan of symlin, it often makes me feel like crap. but, i was having some gastrointestinal issues before i was on it, and they have pretty much stopped. so i keep taking it. i already wear an omnipod, and i dont think i could deal with another thing stuck to me all the time. the symlin injections also suck. they actually hurt, and i get bruises from it. it doesnt happen when i give myself a shot of insulin. i deal with it for now, but i hope that this is not going to be a lifelong medication!
Posted by: sari | July 22nd, 2008 at 5:53 pmi love symlin. it took me three months to get used to it but my post-prandials are SO much better with it and i never take insulin for snacks anymore just symlin. we wrote about the pen in diaTribe in issues #2 and #8 – http://www.diatribe.us/issues/8/test-drive.php – I agree it isn’t for everyone by a stretch! I like the idea of wearing it in a pump because it’s much more “nature’s way” — everyone without diabetes makes a substance like symlin (pramlintide) throughout the day so it’s better having it in a pump. i wore a second omnipod for awhile with it and loved it but it was too expense as my insurance didn’t cover it. The FDA has actually rejected symlin use for type 2s not already on insulin and hasn’t explained why – there were no safety issues at all in the study Amy cited so it seems very strange. I sometimes think it’s more of the same for type 2s – the FDA or at least their advisory board seems to insist “you have insulin and metformin, what else do you need?” They seem to have no idea about side effects like weight gain and hypoglcyemia. Alas! I’ll keep the SymlinPen for now but I’d love to try a pump that my insurance company would reimburse!
Posted by: kelly close | July 24th, 2008 at 1:23 amMy doctor recommended Symlin to me before it came in pen form. I used to fill insulin pens with Symlin instead (not advisable unless you’re an out of the box thinker and doer)and that worked great. I felt nauseous, dizzy, and bitchy. And, I didn’t eat nearly as much as I would have without taking Symlin. But when the Symlin would run out of my system before I dosed again, I’d feel STARVED. So I stopped taking it. I don’t want to be on any other medication for the rest of my life if I don’t have to be and the results I got were not beneficial as they seem to be to many others.
Posted by: Emily Bertman | July 29th, 2008 at 5:47 pm