Diabetes Self-Management Blog

Last Thursday morning I saw my endocrinologist and was really happy to find out that my A1C had dropped 0.6 points. I owe that success to my decision, made with the encouragement of my endo, to start taking Symlin (pramlintide) again.

I had tried Symlin four years ago, a few months after my daughter was born, and I never really adjusted to it. I hated the way that taking it made me feel slightly nauseous while I was eating, and more importantly, I never managed to adjust my insulin to the right dose with the Symlin: I would cut down too much on my premeal bolus and have a high blood glucose reading after eating, or I would take too much insulin with my Symlin and quickly get low blood glucose. Dealing with a newborn baby, a two-year-old, and Symlin proved to be too much of a challenge for me, and my kids weren’t going anywhere, so I said goodbye to Symlin.

Fast-forward to now: Giving it a second try, I have discovered that I LOVE Symlin. My endocrinologist helped me start taking it gradually so that I could better adjust my boluses and monitor how the Symlin affected my premeal boluses. We worked together to fine-tune my insulin adjustments, and within a few weeks, I started taking a full dose of Symlin with most of my meals. Rather than feeling nauseous after eating, I just notice myself experiencing a feeling of being full, and at that point, I stop eating. When I take Symlin, I have a definite, more noticeable sensation of getting full that is helping me to cut down on calories.

But the most significant victory is that it has been so much easier to keep my post-meal blood glucose readings in the optimal range, even as I cut back on the amount of insulin that I’m taking. And no doubt, this more effective post-meal control is what caused my A1C to drop.

Which all made me think about how thankful I am that my endo brought up the idea of revisiting Symlin, even though I had been so adamantly against taking it after my first experience. Being open to try it a second time makes me think about how, to maintain optimal health, we need to keep an open mind. I admit, when I first heard the word “Symlin,” I could feel myself getting resistant. But something in me made me push through the resistance. It was with this push that I allowed myself to feel open and excited about the fact that maybe this time around, my Symlin experience would be different.

As I reflect now, it wasn’t the Symlin that didn’t work last time — it was the timing in my life. I was totally exhausted being a mom of a baby and toddler and no doubt was too cloudy in my thinking to work out my insulin/Symlin balance. It was not easy to manage Type 1 diabetes during those days and adding something new into the mix threw me off balance.

Thankfully, I’m in a different place in my life now and adding Symlin to my daily regimen has been a wonderful opportunity for me to achieve better blood glucose management.

Have you tried Symlin? What has it been like for you? I would love to hear about your experiences with it… or about anything that you’ve “revisited” to discover that the second (or third… or fourth…) time around, it became an effective diabetes tool.


  1. I am taking Symlin now due to high sugar readings due to the heat. Do you notice a change in your sugars druing the Summer months? I take 10 U with meals. The endo wants me to use a sliding scale so I do cut back on the Humalog (1/2 of what I usually take ) and this works well for me. I can deal with the nausea, if I can get better readings, 15 min. of nausea is well worth it.

    Posted by Brenda |
  2. I agree with you — a short period of nausea is really worth the results! Mine is generally 5–10 minutes and very mild.

    Posted by Gabrielle |
  3. I have been taking Symlin for 5+ years. I’m one of those Type I diabetics who goes down, down, down with 1.0 unit of insulin. After 53 years of insulin and 28 years on a pump, BG results kept getting harder to control so I purchased a Dexcom and am paying for my own sensors because Medicare isn’t interested in doing that. The Dexcom has allowed me to see what’s been happening all these years. My BG’s are far better, but of course, never good enough. I had to find a new endocrinologist and nurse practitioner in my area and they are more interested in changing my symlin doses than adding more insulin which has been the case in the past. I’ve been on 40 units of symlin prior to each meal, and now have changed dinner to 50 units of symlin. I don’t feel very hungry, and I’m not nauseas from it. Can anyone advise me on their own experience, or give me websites where I can go to learn more about dosing. I’d appreciate your help! Thanks

    Posted by Betty |
  4. Symlin has a website with information at . If you enroll in the support program you can get a carrying case for your Symlin pens and a large amount of instructional material. The Symlin support program is also available by phone Mon-Fri 8 AM to 8 PM and 9 AM to 5 PM Sat and Sun @ 1-888-796-5461 (1-888-SYMLIN).

    Posted by Rachel |
  5. I’m trying Symlin for the second time. I also have low blood sugar at first and then it goes too high. I know it will go up - so I tend to let it stay low at the beginning - but don’t like how it affects me. Are you using the Combo/Extended bolus and if so - do you use 50-50% or what seems to work for you? Or is that depending on where you are at the time with bs and what you are eating as to how long - 2 1/2 hours, etc.

    Posted by Judy |
  6. I’ve been taking Symlin for a few months now and my sugars are leveling off I find it easy to use although the first 3 weeks I was on 60 instead of 120 I had real bad nausea but allowing the longer adjustment at the lower dose omgoodness success! as an added bonus I have lost 32 lbs in 8 weeks time. every time I see the dr I am down a few more pounds, I have other health issues that prevent me from exercises or being more active but as soon as those are cleared I hope to increase my activity I’m curious to see the effects then, I know Symlin is not a weight loss medication but it has been a huge tool in helping me control my sugar and control my food portions, it gently reminds me ok enough is enough and where I have to consume a meal of at least 250 cal or 30g of carbs I now am more concious of labels it has been an awesome tool for me.

    Posted by Trisha |

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