A person with diabetes mellitus who experiences frequent, wide-ranging fluctuations in blood glucose levels is said to have brittle diabetes. This occurs almost exclusively in people with type 1 diabetes. Because their bodies produce little to no insulin, people with type 1 diabetes rely on scrupulous management of food intake, activity level and properly timed insulin dosing to avoid extremely high or low blood sugar. Symptoms of brittle diabetes reflect both extremes of blood glucose levels.
Increased Urinary Frequency and Volume
During an episode of hyperglycemia or elevated blood sugar, a person with brittle diabetes typically experiences increased urinary frequency and urine output. High concentrations of blood sugar exceed the kidneys' ability to retain it. This causes high glucose levels in the urine, notes the University of Maryland Medical Center. High glucose content in the urine leads to excessive water loss through the kidneys. The result is increased urine production and the need to urinate with increased frequency.
Thirst and Increased Fluid Intake
Loss of water through the kidneys during an episode of hyperglycemia typically causes increased thirst and fluid intake, advises the Mayo Clinic. Without access to fluids to replenish the urinary loss of water, hyperglycemia may cause dehydration.
Hunger
Uncontrolled diabetes causing abnormally high or low blood sugar levels may precipitate extreme hunger, according to "The Merck Manual for Healthcare Professionals." In both situations, the body tissues are not receiving sufficient glucose and are starved for energy leading to increased hunger. Frequent recurrence of this symptom in a person with type 1 diabetes raises suspicion for a brittle state.
Weakness
People with brittle diabetes are often plagued with episodic weakness. The American Diabetes Association notes weakness may indicate an exceedingly high or low blood glucose level. As with hunger, weakness is a symptom of insufficient glucose delivery to the muscles of the body. Without sufficient glucose for energy, the muscles are weak.
Irritability
Irritability can be a symptom of an abnormally low or high blood sugar level, advises the Mayo Clinic. Both situations occur frequently in a person with brittle diabetes. With a hypoglycemic episode, irritability is typically sudden in onset. With hyperglycemia, this symptom may be more protracted. In general, brain cells are better able to tolerate elevated blood sugar levels compared to severely low blood sugar levels.
Shakiness and Clumsiness
The American Diabetes Association points out that sudden onset shakiness and clumsiness are typical symptoms of hypoglycemia, which may occur frequently with brittle diabetes. Without sufficient sugar to fuel the brain and muscles, movements are jerky and uncoordinated.
Confusion and Speech Difficulties
The National Institute for Diabetes and Digestive and Kidney Diseases advises confusion and speaking difficulties such as slurred speech or difficulty putting together coherent sentences are common symptoms of a hypoglycemic episode. The brain relies on sugar from the blood for fuel. Without sufficient glucose, the brain cannot function normally causing a state that may mimic intoxication.
