- Brittle diabetes is a form of type 1 diabetes that is marked by uncontrollable, frequent and severe episodes of fluctuating blood sugar levels.
- People living with this condition typically experience either hypoglycemia or hyperglycemia.
- The condition is rare, affecting more women than men in their young adulthood.
Brittle diabetes mellitus, also called “labile” diabetes, is a form of insulin-dependent diabetes that is marked by unstable blood sugar levels that are hard to control. People with this condition often experience severe bouts of extremely low blood sugar levels (hypoglycemia) which suddenly shifts to very high sugar levels (hyperglycemia) or vice versa. It is always linked with type 1 diabetes, not a separate type of diabetes but regarded more as a subtype of the disease.
Who gets it?
Brittle disease is relatively rare. It affects women more often than men and typically occurs during young adulthood. Due to some cases where brittle disease is seen rarely among people over 40 years of age, research suggests that the disease may resolve itself over time.
You may be raising your risks as well if you often experience unpredictable episodes of very high and very low blood sugar without any obvious cause.
Symptoms of Brittle Diabetes
Symptoms can be different depending on which direction your blood glucose level is going.
If levels are very low, symptoms may include: nervousness, feeling shaky, sweating or chills, rapid heartbeat, nausea and dizziness, headache, seizures or unconsciousness.
Whereas, when blood sugar shoots up, symptoms will likely include: frequent urination, extreme thirst, fatigue, headache and blurred vision.
However, if left untreated, it can progress into a more serious condition called ketoacidosis and/or severe hypoglycemia.
What Causes Brittle Diabetes?
Most cases of brittle disease are frequently associated with either psychological issues or digestive inconsistencies or disorders.
Psychological issues such as depression or stress can bring on acute and temporary insulin resistance which may explain the sudden fluctuations in glucose levels. This may make it hard to predict insulin dosage since the body doesn’t respond to insulin.
Brittle diseases may also be caused by altered digestion, a result of nerve damage or other conditions including celiac disease or malabsorption. Autonomic neuropathy or damage to the nerves that manage daily body functions can cripple the digestive processes and further damage stomach and intestine functions. Not knowing when food will be digested can make it difficult to determine when or how much insulin should be given.
Other causes of unstable blood glucose levels include: insulin absorption problems, gastoparesis, and drug or alcohol use.
Living with Brittle Diabetes
Since brittle diabetes involves the unmanageable rises and drops in glucose levels, a reduced carbohydrate diet is recommended to lessen the severe swing, which in turn, lessens the frequency and severity of the spikes and dips.
Additionally, people have more chances of regulating their blood sugar levels more effectively with diabetes technology such as insulin pumps, continuous glucose monitors or flash glucose monitors.
You may be qualified to use one or more of these technologies in the UK especially if the disease or severely disrupting your chance of leading a relatively normal life.
How to Manage Brittle Diabetes
Knowing the factors causing brittle diabetes is the first step to choosing the appropriate treatments that are needed to address the causes.
If autonomic neuropathy causes your sharp highs and lows, advice from your diabetes team may be provided to help you safely control your insulin doses.
But if it’s caused by psychological issues, talking therapies and mindfulness-based therapies may be suggested by your health team in tackling issues like stress, anxiety and depression