What Is Brittle Diabetes?

Brittle diabetes, also known as labile or uncontrolled type 1 diabetes, is characterized by unexpected and unpredictable wide swings in blood sugar levels.

Establishing Glycemic Control

• In most type 1 diabetics, the relationship between insulin, exercise and food intake produces predictable results. The person knows if he follows his diet, exercises and takes his insulin as directed, his blood sugars will be within a certain range. If glycemic control is lost, these basic factors are tweaked to regain control.

Yo-yo Effect

• For the brittle diabetic using tight control, her diabetes can be stabilized for awhile and suddenly, without notice or provocation, her blood sugar can rise to 500 or more, or drop below 80. Most brittle diabetics describe their experience as being a yo-yo.

Warning

• These wild swings in blood sugar level are devastating to the body and quality of life. Most diabetic complications result from uncontrolled blood sugar levels.

Rare Phenomenon

• Brittle diabetes is rare and affects less than 1 percent of type 1 diabetics, according to diabetic live.com. It is not just uncontrolled diabetes due to factors such as noncompliance; the Dawn Phenomenon, where blood glucose rises overnight, producing high fasting blood sugars; or the Somogyi effect, which is basically a hyperglycemic rebound after a hypoglycemic episode.

Theories/Speculation

• The cause of brittle diabetes is unknown, but there is some hope that there may be a link to hormonal factors such as thyroid and/or adrenal insufficiency. Mental health is another suspect. Stress and depression have been shown to affect glycemic control, but careful assessment is needed to determine self-neglect issues first.