Can the new drug Symlin help my overweight dad with diabetes?
My dad is overweight and has had type 2 diabetes for years. He's heard about a new injectable diabetes drug called Symlin that might help him lose weight. Could this medication help my father?
Expert Answer
The medication pramlintide (brand name: Symlin) may be an excellent addition to your dad's drug regimen if he already takes mealtime insulin and wants better blood sugar control after eating. Symlin is a synthetic hormone that mimics the actions of a hormone secreted by the pancreas, called amylin, which helps insulin work better. The cells of the pancreas that make insulin, the beta cells, also make amylin. In people like your dad with long-standing type 2 diabetes, the function of the beta cells decreases over time, and so production of both insulin and amylin also drops off. Symlin does three things that amylin normally does: It helps your parent's liver release less sugar into the blood, food moves through your parent's stomach more slowly after meals (which also sends sugar into his blood more slowly), and it makes your parent's brain think he's full sooner at meals -- that's why many people taking the hormone lose weight while on this medication.
Like many other hormones, Symlin can only be given as an injection. It's given in addition to mealtime insulin before a meal (the two can’t be mixed). Many people experience nausea or vomiting when this medicine is first started but these side effects tend to disappear over time. Another common side effect is low blood sugar. For this reason, when Symlin is added the dose of mealtime insulin is usually decreased to half the original dose and the dosage of Symlin is slowly increased as your parent can tolerate it. Your parent will need to take both his insulin and Symlin as prescribed and be able to adjust these dosages as necessary, by following his doctor's instructions. It's also important that your parent check his blood sugar often -- before and after every meal and at bedtime -- to avoid a severe blood sugar low.
A new pen injection device, approved in October 2007, makes administration of this medication much easier. It's also available in a vial and can be used with a syringe. As with any diabetes medications -- new or old -- if your parent experiences side effects that bother him or don't go away, you and he should discuss these concerns with his diabetes doctor.