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February 16, 2007

Insulin Pumps, Other Medications

Question from New York City, New York, USA:

My daughter has extreme problems with insulin resistance and often runs high numbers for no apparent reason. Her doctor has admitted she doesn't know what's wrong. She has placed my daughter on a second pump for Symlin. Have you ever heard of this approach and what do you think of it? The practical issues of wearing two pumps are troublesome. If this works, I think my daughter will have to go back to insulin injections and wear just one pump for the Symlin.

Answer:

There are numerous individuals across the country that have tried or are trying to pump Symlin. First, there is no FDA approval to pump it. It does match the Symlin theory, that the body produces Symlin just like insulin, and therefore the basal/bolus delivery is most like true replacement. Second, we are seeing that Symlin sites only last for two days. Changing both sites every two days is a must to decrease rates of infection and to prevent scar tissue build up. Third, two pumps are a lot to wear long term and insurance companies will not approve a pump for Symlin at this time. Another alternative would be to try Byetta, which is a twice a day drug. It works like Symlin, but also stimulates the pancreas to produce insulin, which does not happen in someone with type 1. That is not pproved for type 1, but clinicians are using it with some success to treat insulin resistant type 1 diabetes, especially in teens. The nice thing is she will still pump insulin, which is the best way to deliver it and still get the benefits of amylin.

NB