Brittle diabetes: What you should know

Brittle diabetes, often referred to as labile diabetes, is an uncommon condition of diabetes. It explains when a person’s blood sugar levels fluctuate dramatically and unexpectedly, causing significant disruption in their lives.

Blood glucose levels in people with brittle diabetes are known to fluctuate dramatically. The person’s blood sugar level may swiftly go from low to high (hypoglycemia) or vise versa. This sudden drop in blood sugar is not only inconvenient, but it can also lead to health problems.

Brittle diabetes is discussed on this page, including its meaning, causes, and symptoms.

What is it?

brittle diabetes

Brittle diabetes, also known as labile diabetes, is a word that defines a rare kind of diabetes that is difficult to manage. While the American Diabetes Association (ADA) does not accept the word, it does note that people may use it to describe significant blood sugar fluctuations.

Blood sugar levels in people with brittle diabetes can suddenly fluctuate from too high to too low and vice versa. Glycemic control episodes can be difficult to foresee, affect a person’s quality of life, and lead to hospitalization and consequences.

Brittle diabetes is a descriptive term that might come across as patronizing to some people, as well as conveying a sense of blame, which is incorrect. “Unstable diabetes” or “dangerous diabetes,” according to researchers, would be a more accurate term. In many circumstances, a medical condition, aging, or healthcare inequity may be the cause of the condition.

When to consult a doctor

If a person begins to suffer symptoms of hypo- or hyperglycemia on a regular basis, he or she should see a doctor. Knowing the warning symptoms of diabetic emergencies and how to respond quickly could save lives.

If someone has seizures or coma, they should seek medical help right once. It’s especially important to see a doctor if you have any of the following symptoms on a regular basis:

  • difficulty breathing
  • vomiting
  • rapid heart rate
  • confusion
  • nausea

Risk factors and causes

People with type 1 diabetes have the highest risk of developing brittle diabetes, according to research. Individuals with long-term type 2 diabetes are more likely to develop the condition, but this is a rare occurrence. Despite the fact that brittle diabetes can afflict people of any age, evidence suggests that girls are more likely to be affected than males.

The actual cause is unknown, but according to a 2021 article, a number of variables could contribute to brittle diabetes’ hallmark glucose instability. There are four kinds of people who are more likely to develop brittle diabetes, according to the study:

  • older adults who have difficulty managing their diabetes
  • individuals without access to sufficient insulin who may also experience food insecurity
  • younger individuals with mental health complications
  • people with an underlying medical condition affecting their insulin sensitivity or glucose utilization

Potential factors that may affect diabetes and make it difficult to control, according to research, include:

  • emotional stress
  • substance misuse
  • eating disorders
  • hormonal imbalances
  • malabsorption of insulin or nutrients, or health conditions affecting digestion
  • difficulty adhering to the treatment plan, such as not checking blood sugar regularly or not taking medications as prescribed
  • hypoglycemic unawareness

A case study from 2021, for example, features a person who has brittle diabetes as a result of an undiagnosed autoimmune condition called celiac disease.

Symptoms

A person with brittle diabetes would most likely suffer abrupt and frequent variations in their blood glucose levels. As a result, individuals may have bouts of acute hyperglycemia and periods of severe hypoglycemia, which can lead to diabetic ketoacidosis.

Hypoglycemia can cause the following symptoms:

  • confusion
  • seizures
  • fainting
  • tiredness
  • sweating
  • coma
  • hunger
  • shaking
  • rapid or irregular heart rate
  • dizziness and weakness

Hyperglycemia can cause the following symptoms:

  • blurred vision
  • unexplained weight loss
  • fatigue
  • irritability
  • frequent urge to urinate
  • excessive thirst
  • intense, unusual hunger
  • headaches

Diagnosis

Brittle diabetes is characterized by frequent and severe blood glucose variations, as well as episodes of hyper- and hypoglycemia that may necessitate hospitalization. As a result, a diabetes specialist can examine a person’s blood glucose levels over time and diagnose brittle diabetes.

Attempts are being made to specify diagnostic criteria in ongoing research. According to a recent scientific experiment, a person with brittle diabetes has at least two of the following characteristics:

  • diagnosis of unaware hypoglycemic episodes
  • a score suggesting high glycemic variability according to different tests, such as low and high blood glucose indices and a mean blood glucose standard deviation
  • persistent, severe hypoglycemia
  • ketoacidosis without an obvious cause

Treatment options

The condition will be treated and managed in a similar way to type 1 diabetes, with people monitoring their blood glucose levels and keeping them within healthy ranges. Typically, treatment entails insulin administration as well as dietary and activity modifications.

Some people may employ technologies and technology to detect and manage their blood sugar levels, such as a continuous glucose monitor or an artificial pancreas. If people are qualified, they may undergo a pancreas or islet cell transplant in other circumstances.

A doctor will recommend the appropriate treatment for each individual. They’ll also look at any underlying issues that could be causing your brittle diabetes. If stress or a mental health condition is the cause, they may recommend therapy.

Outlook

Because brittle diabetes is linked to type 1 diabetes, the two illnesses are treated similarly. People should check their glucose levels on a frequent basis and follow their doctor’s advise to help control their blood sugar. Eating a well-balanced diet, exercising regularly, and correctly delivering insulin are all examples of this.

There is currently a scarcity of research on the life expectancy of people with brittle diabetes. People who are unable to successfully control their blood glucose, on the other hand, are more prone to develop health problems that can shorten their life expectancy.

Males with type 1 diabetes had a life expectancy of around 66 years, compared to 77 years for individuals without the condition, according to research. Females with type 1 diabetes have a life expectancy of roughly 68 years, compared to 81 years for those who do not.

Because brittle diabetes is characterized by substantial swings that are difficult to manage, life expectancy is likely to be affected. Advances in technology and management, on the other hand, are assisting in dramatically increasing life expectancy.

Prevention methods

People may not be able to prevent brittle diabetes depending on the underlying cause. Maintaining good blood glucose levels and using insulin and diabetes technology are the best techniques people can use. It’s also a good idea to keep frequent doctor’s checkups and try to control any underlying health issues.

Conclusion

Brittle diabetes is a word used to describe a kind of diabetes that is uncommon and difficult to maintain. It is characterized by frequent and dramatic swings in a person’s blood glucose levels, which can cause significant disruption in daily living. It usually happens as a result of circumstances that impair the body’s ability to use nutrition and insulin.

The treatment is identical to that for type 1 diabetes, and includes blood glucose monitoring and insulin administration. However, a person’s underlying causes of brittle diabetes may necessitate extra treatment.

Sources:

  • https://rarediseases.info.nih.gov/diseases/11900/brittle-diabetes
  • https://www.diabetes.org/resources/students/common-terms
  • https://www.medicalnewstoday.com/articles/brittle-diabetes
  • https://www.diabetes.org/healthy-living/devices-technology
  • https://www.diabetes.co.uk/diabetes-life-expectancy.html
  • https://www.niddk.nih.gov/health-information/diabetes/overview
  • https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7266594/
  • https://jamanetwork.com/journals/jama/fullarticle/2088852
  • https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4543190/
  • https://www.asean-endocrinejournal.org/index.php/JAFES/article/view/1145