(Background: Parts 1, 2, and 3)
All right, folks. The time has come. I am taking the first steps toward trying to mix Symlin and insulin, in order to more closely imitate life with a working pancreas.
I have my Symlin, and I’ve obtained some pH strips. I was originally aiming for a more full-blown pH meter, but the only ones I could find to borrow were heavy-duty lab equipment, and, given my new status as an impoverished grad-student-researcher, and the high price of Symlin, I couldn’t justify purchasing my own. So good, old-fashioned pH strips it is!
Now, one thing I should be absolutely clear about: this is not a scientific trial. This is not a clinical evaluation. This is barely even an experiment. This is me, on my own, trying a few things out on the weekend when I have the time and inclination, seeing if I can make living with diabetes a tad more flexible and similar to the natural pancreatic experience. My metric of success will not be scientific analyses; it will be, “Does this make things easier for me overall, so as to be worth the hassle and the price? Can I do this on a regular basis, and not put myself in danger?” If a nanoliter of extra Symlin, or an air bubble, or one shake too many makes a big difference, this likely will not be a long-term viable solution.
In other words, please, do not try this at home.
With that forewarning out of the way, I move on to step one: mix insulin and Symlin in a vial; track pH and observable precipitation over a couple of weeks. I will prepare three separate vials– one to sit at room temperature, unperturbed; one to sit in the sunshine, heating as much as possible in a black bag; and one to carry with me, jostling around in my purse as I jostle throughout the day. (Note that phase 1 does not involve me taking any Symlin!)
One important point of consideration is the ratio of Symlin and insulin that I choose. In theory, I’d like to imitate what my pancreas would be doing if it had beta-cells; so, I ask, how much amylin would my pancreas secrete if my pancreas could secrete amylin?
Most of the studies available about the natural, pancreatic ratio of co-secretion are done on rats and other animals, and the studies I’ve found differ somewhat on the exact nature of amylin secretion, depending on the brand of rat being observed, the experimental scenario, and the glucose infusion rates. One study saw amylin secreted 25 – 37% as much as insulin; one study saw much variance in the rates of secretion of amylin and insulin, with the total amount settling at 8.9%; and one study approximated the ratio of amylin to insulin at 10%.
So where does that leave me? I’m going with 10%. Why? Well, to begin with, it’s a nice, easy-to-calculate-and-remember number– and that’s important, because the whole point of this experiment is to make my life easier, and not harder. If I gain some flexibility in glucose control, but get all tied up trying to mix and meddle with the drugs, then my net benefit is reduced. Secondly, I familiar with insulin, and not Symlin– so starting with a little bit, relatively speaking, seems like a safer, more comforting plan. And finally, Symlin, as I have noted, is extremely expensive– so weighting my mixture in favor of insulin is a cost-effective approach.
With a 10% Symlin to insulin ratio decided on, I can set up my vials. I am using syringes to measure and transfer the two liquids, left out of the refrigerator for about an hour to reach room temperature, into spare pump cartridges I have (did I mention this wasn’t a precise, scientific endeavor?). Photograph, test pH, distribute, and wait. I’ll let you know how it goes!
Please note: I am not a doctor, or a medical professional, or even a chemist. The above is intended to be purely informational, and is based on my own research; it has not been independently verified, and is not medical advice.
 |
The tools. (It’s been a really long time since I’ve used syringes!) |
 |
Symlin on the left with a pH falling off the acidic end of my 4.0 – 7.0 scale; Novolog on the right hitting somewhere close to 7.0; and the mix in between, falling somewhere in between 5.8 and 6.1. |
 |
My three soldiers, loaded with 55 units each and ready for battle! |
This is fantastic! Keep us posted! I’ve always wanted to try mixing Symlin into the Novolog in my pump, but, as I lack your chemistry background, my step 1 would involve dosing myself with an experimental mix, and I’ve been too nervous to try. Can’t wait to see what happens with those vials!