What is Brittle Diabetes?

Brittle diabetes is a form of type 1 diabetes with unstable blood sugar levels that cause a variety of health problems. While just 1 to 2 percent of people with type 1 diabetes get brittle diabetes, it is considered one of the most dangerous types of diabetes and can lead to a shortened lifespan. Learn more about brittle diabetes and what can be done to treat it.

• Brittle diabetes also referred to as volatile or labile diabetes is a type of uncontrolled type 1 diabetes. People typically experience large swings in their blood glucose levels. While hyperglycemia (high blood sugar) is more common, people may also experience ongoing hypoglycemia (low blood sugar). It is important to constantly monitor blood sugar levels and report extreme highs and lows to the doctor immediately.
• Other conditions may help cause brittle diabetes including gastrointestinal absorption problems, hormone malfunction, delayed stomach emptying (referred to as gastroparesis) and drug interactions. People with low blood sugar may have hypothyroidism or adrenal insufficiency. When these conditions are properly treated brittle diabetes might be resolved.
• Psychological problems such as stress and depression are also associated with brittle diabetes and should be treated right away. People with psychological issues may also neglect their diabetes self-management plan and might need to be carefully monitored.
• People with brittle diabetes experience frequent blood sugar fluctuations that impact their ability to carry out daily activities. The person may be hospitalized often, miss work and deal with related psychological issues. This can place stress on work associates and family members. They should be told the person has brittle diabetes and what may come along with it.
• Brittle diabetes is most common in young women but can also occur in young men. Overweight women are more likely to be affected by the disease. People with brittle diabetes are most likely to be between the ages of 15 and 20. It can be a long and challenging process to diagnose brittle diabetes and its underlying causes. A new health care team and updated diabetes management plan can be effective. Psychotherapy can be helpful for people with brittle diabetes and psychological problems.
• People with ongoing blood sugar fluctuations might require a prolonged hospital stay that includes monitoring of glucose, insulin and food. If brittle diabetes is caused primarily by physical issues, it can be beneficial to use an insulin pump to control blood sugar levels more precisely. It may also help to use a CGM or continuous glucose monitor system to see blood glucose trends which can anticipate highs and lows. In severe cases, a pancreas or islet transplant might be considered. This only happens when all other means of glucose management have been exhausted as there are significant risks associated with transplantation.
• People with brittle diabetes must be closely supervised by their diabetes care team to get all necessary education and ensure the underlying causes are treated. It is also important for the patient to get support from family, friends and co-workers who understand the disease. Careful self-management and ongoing blood sugar monitoring are essential to keep symptoms at bay.

Brittle diabetes requires ongoing care, treatment and attention. Treating the underlying causes and getting blood sugar levels in check can ward off the symptoms of brittle diabetes. Medical and personal support is essential for patients with brittle diabetes.