What Is Brittle Diabetes?

Brittle diabetes is the name doctors give diabetes that is especially hard to control. It’s also called “labile” diabetes. The words brittle and labile can both mean “unstable” or “easily changed.”

When you have brittle diabetes, your blood glucose levels often swing from very low (hypoglycemic) to very high (hyperglycemic).

It’s almost always associated with type 1 diabetes. It isn’t a separate kind of diabetes, but more like a complication, or subset of the disease.

Causes and Symptoms

Because any diabetes can be unstable when you don’t manage it well, a brittle diabetes diagnosis can be tricky. If your blood sugar levels swing wildly, there could be many reasons for it, including:

  • You’re not taking your medication or testing your glucose levels like you should.
  • Lots of stress
  • An eating disorder
  • Your intestines struggle to absorb nutrients.
  • Celiac disease
  • Gastroparesis — a condition that slows down or stops the emptying of food from your stomach into your intestines
  • You’re very sensitive to insulin

Often, it can be one or more of these. In many cases, doctors don’t know exactly what causes it.

Depending on which way your blood glucose level in swinging, your symptoms can be different. They’re “very low" at below 70 mg/dl. Symptoms can include:

  • Feeling shaky
  • Nervousness or anxiety
  • Sweating, chills
  • Irritability
  • Confusion
  • Fast heart rate
  • Dizziness
  • Nausea
  • Blurred vision
  • Weakness
  • Headache
  • Seizures
  • Unconsciousness

When your blood sugar shoots up above 200 mg/dl, your symptoms will likely include:

  • Frequent urination
  • Extreme thirst
  • Blurred vision
  • Fatigue
  • Headache

If you don’t treat high blood sugar, it can turn into a more serious condition called ketoacidosis. That’s when toxins called ketones build up in your blood and urine.

It can cause:

  • Breath that smells fruity
  • Nausea and vomiting
  • Shortness of breath
  • Weakness
  • Confusion
  • Abdominal pain
  • Coma

Who Gets It?

Brittle diabetes isn’t common. About 3 out of every 1,000 people who take insulin for diabetes will get it.

People of all ages can have brittle diabetes. Women get it a bit more often than men. If you often have bouts of low blood sugar, you may be raising your odds, as well. The more often you’re hypoglycemic, the less you may recognize it. That can make each episode worse and lead to brittle diabetes

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