Johns Hopkins Health Alert
The Challenge of “Brittle” Diabetes
An important goal of diabetes treatment is tight glucose control, which means keeping your blood glucose level as close to normal as possible. But staying in good control is difficult, especially for people with “brittle” diabetes. What does this old-fashioned term mean?
"Brittle" diabetes is sometimes used to describe the condition of patients who have frequent swings in blood glucose levels from very high to very low. It's natural for blood glucose to rise and fall during the day in response to meals, exercise, and other influences. However, people with brittle diabetes (sometimes called labile diabetes) often experience drops and peaks in blood glucose so severe that they require medical attention.
Brittle diabetes is more common in people with type 1 diabetes, but it also can occur in type 2 diabetes. Certain medical conditions may be linked to brittle diabetes, such as gastroparesis (a delay in stomach emptying, which interferes with the timing of carbohydrate absorption after meals) and some endocrine disorders, such as hypothyroidism.
Most often, though, brittle diabetes is a sign that the person is struggling with the inherent challenge of replacing the pancreas's finely tuned production of insulin with the cruder method of injecting this essential hormone.
There are no easy answers for overcoming brittle diabetes. However, gaining control is often a matter of paying closer attention to the daily requirements of managing blood glucose. For example, are you accurately matching your insulin dose to the amount of carbohydrates you eat at each meal? Oftentimes, people find that heeding these kinds of finer details helps minimize the highs and lows.
Posted in Diabetes on August 12, 2010
Reviewed January 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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