Brittle diabetes is a form of diabetes that is characterized by recurrent fluctuations in the blood glucose levels. The condition is rare and occurs in less than 1 percent of cases, says the Boulder Medical Center. It is more common in individuals with type I diabetes due to the complete absence of insulin production and involves frequent hospitalization and emergency room visits. The condition is also associated with increased risk of complications and significant mortality rates.
Causes
More than 50 percent of brittle diabetes cases occur due to psychological factors that lead to noncompliance with treatment, says John K. Davidson, author of the book "Clinical Diabetes Mellitus." Defective absorption or excessive degradation of insulin can also lead to the condition. Excessive insulin and low blood glucose levels also make the body produce hormones that release the stored glucose. This can, in turn, increase the glucose levels in the blood. Certain bone and soft tissue infections may also increase the risk of brittle diabetes.
Symptoms
According to an article published in the March 2001 edition of the journal "Practical Diabetes International," patients with brittle diabetes have several symptoms that are often misdiagnosed. The signs and symptoms fluctuate depending upon high and low sugar levels in the blood and may include frequent urination, increased thirst, loss of weight, blurred vision, confusion, and irritation. The patients experience a poor quality of life due to frequent hospital visits and increased complications. A case study published in 2003 edition of the European journal "Schweiz Monatsschr Zahnmed" reported aggressive inflammation of bone joints in a patient suffering from brittle diagnosis.
Diagnosis
The diagnosis of brittle diabetes is difficult, as the symptoms overlap with the other forms of the disease. In fact, the Boulder Medical Center states that diagnosis depends upon the overall experience of the doctor, patients and the family members. Frequent testing may help to reveal a pattern of the changing blood sugar levels for the patient. Diagnostic techniques such as mean amplitude of the largest glycemic excursions, mean of daily differences, lability index and low blood glucose index may help quantify the fluctuations and diagnose the condition conclusively.
Treatment
Treatment of brittle diabetes depends upon the underlying cause. Patients with psychological problems, along with family members, may receive counseling. An article in the September 2006 edition of the French journal "Ann Endocrino" suggests that adjusting insulin dose may help some patients. More severe cases may require transplantation of certain regions of pancreas to regularize insulin production. Implantable devices that send prescribed amounts of insulin at set intervals may also be used.
Prognosis
Prognosis depends upon the severity of the condition and the promptness of the treatment. While prolonged variations in blood sugar levels may lead to complications and poor quality of life, treatment can help to manage the condition. Talk to your doctor if you suspect frequent changes in blood sugar self-tests.
References
- Boulder Medical Center: Brittle Diabetes Mellitus
- "Clinical diabetes mellitus: a problem-oriented approach"; John K. Davidson; 2000
- "Practical Diabetes International"; Recurrent Hypoglycemia in a Patient with History of Brittle Diabetes; K. Naing, et al; March 2001
- "Schweiz Monatsschr Zahnmed"; Aggressive Generalized Severe Periodontitis and Brittle Diabetes Mellitus Type I, Diagnosis, Treatment and Report of a Case; M. Ruppert, et al; 2003
- "Ann Endocrinol"; Management Strategies for Brittle Diabetes.; M.C. Vantyghem, et al; September 2006
