Be Informed About Brittle Diabetes

Individuals whose bodies cannot produce insulin have type 1 diabetes. It is an unstable condition that requires careful management through medication, diet and lifestyle choices. “Brittle Diabetes” refers to extremely unstable cases of type 1 diabetes. It affects three out of every 1,000 insulin-dependent individuals.

People with brittle diabetes cannot carry out their usual daily activities owed to low blood sugar (hypoglycemia), high blood sugar (hyperglycemia) or sometimes a mix of both.

"Real brittle diabetes doesn’t follow patterns," explains Peter J. Nebergall, Ph.D. "Individuals whose diabetes is 'brittle' experience unpredictable, out-of-proportion rises and swoops in blood glucose, within short periods of time, as a result of very small deviations from schedule."

Eight Things to Know About Brittle Diabetes

1. Both men and women have brittle diabetes, though it is most common in young women. Many individuals who suffer from it are 15 to 30 years old. In some cases, thorough education on insulin management backed by an adequate support network can lessen or resolve a young person’s experience of brittle diabetes.
2. People with brittle diabetes typically have frequent and sometimes lengthy hospitalizations and are often absent from school or work.
3. If a diabetic’s blood glucose levels respond to drug treatment in a hospital or other controlled setting, doctors look for environmental, psychological or behavioral reasons for brittle diabetes.
4. Individuals with mental, emotional or environmental difficulties may not maintain a healthy diet or manage their blood glucose well, setting the stage for brittle diabetes. In these cases, psychotherapy is frequently an effective treatment.
5. The health difficulties and life disruptions of having brittle episodes are stressful, anxiety-producing and depressing, possibly triggering mental health problems. When these occur, support groups and psychotherapy are helpful supplements to other treatments.
6. Possible physical causes of brittle diabetes is defective insulin absorption, drug interference (e.g., alcohol, antipsychotics), a defect related to hyperglycemic hormones such as glucagon and glucocorticoid, and delayed gastric emptying (emptying of the stomach) caused by autonomic neuropathy.
7. When the cause of brittle diabetes is determined to be physical, the use of a continuous insulin pump may be recommended to control glucose levels as precisely as possible. People with severe brittle diabetes and who have exhausted other means of blood glucose management may be asked to consider islet or pancreas transplantation.
8. Treatment of all brittle diabetes should ideally involve a multidisciplinary team including the patient, a diabetes specialist, primary care doctor, nurse, dietician, psychologist/psychiatrist/psychotherapist, podiatrist, family, and friends.

Sources: InTechOpen
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