Brittle diabetes is characterized by marked fluctuations in blood glucose levels. It can occur in type 1 and type 2 diabetics, but it is more common in type 1 diabetics although the incidence is very low. A review article in the September 2006 issue of "Annales d' Endocrinologie" reports that the incidence of brittle diabetes is 3 per 1000 in type 1 diabetic patients. Persistently high glucose levels play a role in causing the complications of diabetes. These complications include cardiovascular disease, kidney, eye and nerve damage. A study in the journal "Lancet" reports that diabetic complications occurred in 67 percent of patients with brittle diabetes and 25 percent of patients with stable diabetes.
Acute Hypoglycemia
People with brittle diabetes experience more episodes of acute hypoglycemia that require hospitalization. The onset of symptoms typically occurs at blood glucose levels below 65 mg/dL. The symptoms of acute hypoglycemia are shakiness, irritability, anxiety, sweating and headache. In severe cases, the symptoms can progress to seizures, coma and death. An article in the November 2001 issue of the "Journal of the Royal Society of Medicine" reports that 27 percent of elderly patients diagnosed with brittle diabetes experience recurrent episodes of hypoglycemia.
Ketoacidosis
Rapid fluctuations of low glucose levels to very high levels are common in people with brittle diabetes. A major consequence of acute hyperglycemia and low levels of insulin is ketoacidosis, which refers to a metabolic disorder in which glucose and ketone levels are high. Ketones are breakdown products of fat. They are acidic and high levels in the blood cause symptoms of metabolic acidosis including nausea, fatigue, excessive urination and thirst, shortness of breath and confusion. The November 2001 article in the "Journal of the Royal Society of Medicine" reports that 29 percent of elderly patients with brittle diabetes experience recurrent episodes of ketoacidosis.
Heart
The cardiovascular system is the primary organ system affected by diabetes. The ADA notes that in 2004, 68 percent of diabetics who died had heart disease. Those with diabetes commonly have hypertension and are predisposed to strokes.
Kidneys
The incidence of kidney disease in people with diagnosed brittle diabetes is unknown; however, a much higher occurrence of kidney disease is found in diabetics with persistently high glucose levels. The American Diabetes Association reports that 44 percent of cases of kidney failure are caused by diabetes.
Nerves
Nerve damage, or neuropathy, is a common complication in diabetics. Nerve damage can cause gastroparesis, which is a disorder characterized by delayed gastric emptying. A review article in "Diabetes Care" notes that gastroparesis is linked to the development of brittle diabetes.
Eyes
Diabetes is the leading cause of blindness in the United States. According to 2007 data from the ADA, diabetes-related eye damage causes between 12,000 and 24,000 new cases of blindness every year.
References
- "Annales d' Endocrinologie"; Management Strategies for Brittle Diabetes; M.C. Vantyghem and M. Press; September 2006
- "Lancet"; Mortality and Outcome of Patients with Brittle Diabetes and Recurrent Ketoacidosis; L. A. Kent et al.; September 1994
- "Journal of the Royal Society of Medicine"; Brittle Diabetes in the Elderly; Susan J Benbow et al.; November 2001
- "Diabetes Care"; Diabetic Autonomic Neuropathy; A. Vinik et al.; May 2003
- American Diabetes Association: Diabetes--Basics
