Diabetes Mellitus Brittleness: Characteristics, Signs, and Predisposing Factors
Brittle diabetes, also known as labile diabetes, is a rare and difficult-to-control form of diabetes that predominantly affects people with type 1 diabetes. This condition is characterised by unstable blood glucose levels, leading to frequent and sudden fluctuations.
People requiring immediate medical care are those who experience seizures or coma, or those who frequently experience symptoms such as confusion, nausea, difficulty breathing, vomiting, rapid heart rate, and other signs of hypo- or hyperglycemia.
Brittle diabetes is most commonly caused by a combination of psychological, physiological, pharmacological, and social factors that impair stable blood glucose control and insulin management. Mental health disorders, such as eating disorders, inconsistent insulin absorption due to lipohypertrophy, other medical conditions that affect insulin sensitivity, cognitive impairments, and socioeconomic factors like inability to afford or access insulin and related diabetes care supplies are major contributors.
While the term "brittle diabetes" is increasingly considered outdated, these risk factors still characterise the unstable glycemic patterns it describes. The condition can affect people of any age, but it may affect females more often than males.
Treatment options for brittle diabetes are similar to those for type 1 diabetes, including monitoring blood glucose levels, maintaining them within healthy ranges, and adjusting diet and exercise. People may also use devices and technology, such as a continuous glucose monitor or artificial pancreas, to help track and manage their blood sugar levels. In some cases, people may be eligible for a pancreas or islet cell transplant.
The American Diabetes Association does not recognise the term "brittle diabetes," but it notes that people may use the term to refer to extreme fluctuations in blood sugar levels. The exact cause of brittle diabetes is unknown, but many possible factors may contribute towards the characteristic glycemic instability.
Despite the challenges, advances in technology and management are helping significantly improve life expectancy for people with brittle diabetes. The outlook for people with brittle diabetes is similar to that for people with type 1 diabetes, with regular monitoring of blood glucose levels and following a doctor's advice being crucial.
If a person begins to experience symptoms of hypo- or hyperglycemia frequently, consulting a doctor is advisable. Regular doctor appointments and managing other underlying health conditions are also essential for people with brittle diabetes. The life expectancy for people with brittle diabetes may be affected due to the severe fluctuations in blood glucose levels, leading to symptoms such as hunger, tiredness, sweating, shaking, rapid or irregular heart rate, dizziness and weakness, confusion, seizures, fainting, coma, frequent urge to urinate, excessive thirst, intense, unusual hunger, headaches, blurred vision, unexplained weight loss, fatigue, irritability, and brittle diabetes may also cause people to experience hormonal imbalances, malabsorption of insulin or nutrients, difficulty adhering to the treatment plan, hypoglycemic unawareness, emotional stress, substance misuse, eating disorders, and underlying medical conditions affecting insulin sensitivity or glucose utilization.
A current clinical trial is suggesting diagnostic criteria for brittle diabetes, including persistent severe hypoglycemia, ketoacidosis without an obvious cause, diagnosis of unaware hypoglycemic episodes, high glycemic variability according to different tests, low and high blood glucose indices, and a mean blood glucose standard deviation.
In conclusion, while brittle diabetes is a challenging condition, with the right care and management, people with brittle diabetes can live healthy and fulfilling lives. Regular monitoring, adherence to treatment plans, and open communication with healthcare providers are key to managing this condition effectively.
- Science is increasingly focusing on the complex factors contributing to the chronic disease known as brittle diabetes, a form of type 1 diabetes characterized by unstable blood glucose levels.
- Mental health, including eating disorders, plays a significant role in the development and management of brittle diabetes, contributing to its unstable glycemic patterns.
- Beyond traditional treatments like monitoring blood glucose levels and adjusting diet and exercise, technology such as continuous glucose monitors and artificial pancreas can aid in managing brittle diabetes.
- Skin care, nutritional balance, and mental health are crucial aspects of overall health and wellness for people with brittle diabetes, as significant fluctuations in blood glucose levels can lead to various symptoms and potential health complications.
- Fitness and exercise play a vital role in maintaining steady blood glucose levels, which is essential for people living with brittle diabetes as this condition is associated with an increased risk for numerous medical-conditions and chronic diseases.
