Brittle Diabetes: Outdated Term Or Neglected Condition?
Brittle Diabetes: Outdated Term or Neglected Condition? Brittle Diabetes: Outdated Term or Neglected Condition? Email addresses will not be shared with 3rd parties. See privacy policy We're sorry, an error occurred. We are unable to collect your feedback at this time. However, your feedback is important to us. Please try again later. Sometimes, my blood sugars drop as low as 40 and then skyrocket up to the 500s during the course of a day. Reasons can vary from specific insulin dosing or carb counting mistakes to laziness on my part... or just because the sun decided to shine brighter, a breeze is blowing a certain way that day, or someone sneezed on the other side of the world. That's just life with diabetes on certain days. As I tend to say, these are days when I'm "riding the glu-coaster ." What I don't say: "I have brittle diabetes." Not anymore, at least. Back in the '80s and '90s, I heard this term quite often from both doctors and patients. My mom, diagnosed as a child herself, was told for decades that she had "brittle" diabetes, and the term's still used by some veteran type 1s, even now. But for the most part, it's considered an outdated label that's faded drastically in the past 15 years. Many medical experts now try to discourage its use, saying the term's a misnomer and only leads to confusion. But some disagree, saying "brittle diabetes" refers not to everyday ups and downs, but rather to a rare but real condition in which the PWD has volatile blood sugar swings that are nearly impossible to control. It's known as labile diabetes in clinical lingo and there are some in the patient D-community advocating to bring more awareness and recognition to this rare and severe form of type 1. The Sorge family from Long Island, New York, is one example of vocal advoca Continue reading >>
Brittle Diabetes: As Knowledge Advances, Aging Term Loses Favor
Brittle Diabetes, a term coined in the 1940s, is considered an antiquated term. As knowledge and technology have advanced, clinicians now recognize that widely variable fluctuations in glucose levels ultimately have an underlying cause. Although, there are still some cases that are more challenging and difficult to manage. As noted, prognosis is poor in patients with “brittle diabetes.” They tend to have lower QOL scores, more microvascular complications, and shortened life expectancies. Three forms have been described: recurrent diabetic ketoacidosis, predominant hypoglycemic forms, and mixed instability. The assessment of brittle diabetes requires quantification of the variability of blood glucose levels. Multiple measuring systems are available to quantify instability, including Mean of Daily Differences (MODD), Mean Amplitude of the largest Glycemic Excursions (MAGE), and Lability Index (LI). Currently, healthcare providers prefer terms such as labile diabetes, glucose variability, or uncontrolled diabetes over the term brittle diabetes. Contributing factors can take investigational work on the provider’s part and often more time than the typical 20-minute appointment. Moreover, the cause can vary from patient to patient. Common etiologies include: inconsistencies in diet and physical activity, psychosocial, medication adherence, proper administration, overcorrection of hypo/hyperglycemia, adherence to self glucose monitoring, asymptomatic hypoglycemia, and other conditions such as depression, alcohol abuse, renal disease, and gastroparesis. Uncovering and treating the cause is the key. Asymptomatic hypoglycemia, a common cause of high glucose variability, can cause resultant hyperglycemia from exaggerated overcorrection upon detection of hypoglycemia. One sol Continue reading >>
Someone I Care Deeply For Has Brittle Diabetes | Diabetic Connect
Someone I Care Deeply For Has BRITTLE Diabetes Someone I care deeply for has BRITTLE diabetes By peachy4372 Latest Reply2017-09-26 10:07:28 -0300 My ex boyfriend (who is the love of my life) has this. The only time he sees a doctor is when he goes into a coma and goes to the hospital. They told him that he is not a canidate for transplant or anythingthat he is too far gone. I love this guy and will for the rest of my life even though we may never date again and I won't accept this. I'm going to try and make him see a doctor on a regular basis. I don't feel like he takes care of himself and eats righthe says he does and I know he is the one living it but I have to do something. I cannot lose him. The doc says he pancreas is basically gone/shriveled up and that he has a year to live. Can this be true..surely that would make him a canidate for a pancreas or islet implant. Thank you Joni 55 for suggesting this site! I wish I knew more about how to help. Please keep us posted on how things go. We are here to celebrate the victories and cry with you in the defeats. Hello Peachy and welcome to the community. Joni told me a little about your situation and I am so sorry for you to suffer this with him. It is good that he is not alone and I hope you have been able to read some of the other discussions on brittle diabetes. It seems such a shame one so young to endure this. My advice is to be there for him and not get naggy. Learn new things you can share with him and be excited about together. I am sure a lot of his "giving up" comes from doctors that don't know what to do with him. He must keep looking for that right connection. There is a doctor out there that will work with him, and I hope together you will find that person. Loving him will be the best thing for him. You canno Continue reading >>
Type 1 Diabetes Linked To Lower Life Expectancy In Study
But, second study suggests that intensive blood sugar management can make a difference Please note: This article was published more than one year ago. The facts and conclusions presented may have since changed and may no longer be accurate. And "More information" links may no longer work. Questions about personal health should always be referred to a physician or other health care professional. HealthDay Reporter TUESDAY, Jan. 6, 2015 (HealthDay News) -- People with type 1 diabetes today lose more than a decade of life to the chronic disease, despite improved treatment of both diabetes and its complications, a new Scottish study reports. Men with type 1 diabetes lose about 11 years of life expectancy compared to men without the disease. And, women with type 1 diabetes have their lives cut short by about 13 years, according to a report published in the Jan. 6 issue of the Journal of the American Medical Association. The findings "provide a more up-to-date quantification of how much type 1 diabetes cuts your life span now, in our contemporary era," said senior author Dr. Helen Colhoun, a clinical professor in the diabetes epidemiology unit of the University of Dundee School of Medicine in Scotland. Diabetes' impact on heart health appeared to be the largest single cause of lost years, according to the study. But, the researchers also found that type 1 diabetics younger than 50 are dying in large numbers from conditions caused by issues in management of the disease -- diabetic coma caused by critically low blood sugar, and ketoacidosis caused by a lack of insulin in the body. "These conditions really reflect the day-to-day challenge that people with type 1 diabetes continue to face, how to get the right amount of insulin delivered at the right time to deal with your blood Continue reading >>
Brittle Diabetes Mellitus | Definition Of Brittle Diabetes Mellitus By Medical Dictionary
Brittle diabetes mellitus | definition of brittle diabetes mellitus by Medical dictionary Also found in: Dictionary , Thesaurus , Encyclopedia . Related to brittle diabetes mellitus: labile diabetes a general term referring to any of various disorders characterized by excessive urination (polyuria); when used alone, the term refers to diabetes mellitus . (See Atlas 4, Part D). brittle diabetes diabetes that is difficult to control, characterized by unexplained oscillation between hypoglycemia and diabetic ketoacidosis . (This term was formerly much used, but it is not a classification used by the World Health Organization or the American Diabetes Association.) central diabetes insipidus a metabolic disorder due to injury of the neurohypophyseal system, which results in a deficient quantity of antidiuretic hormone (ADH or vasopressin) being released or produced, resulting in failure of tubular reabsorption of water in the kidney. As a consequence, there is the passage of a large amount of urine having a low specific gravity, and great thirst; it is often attended by voracious appetite, loss of strength, and emaciation. Diabetes insipidus may be acquired through infection, neoplasm, trauma, or radiation injuries to the posterior lobe of the pituitary gland or it may be inherited or idiopathic. Treatment of pituitary diabetes insipidus consists of administration of vasopressin. A synthetic analogue of vasopressin (DDAVP) can be administered as a nasal spray, providing antidiuretic activity for 8 to 20 hours, and is currently the drug of choice. Patient care includes instruction in self-administration of the drug, its expected action, symptoms that indicate a need to adjust the dosage, and the importance of follow-up visits. Patients with this condition should wear some fo Continue reading >>
What Is Brittle Diabetes…and Are You At Risk?
Brittle diabetes—also called labile diabetes—is a rare but serious form of the disease in which there are dramatic and often unpredictable fluctuations in blood sugar levels. Blood sugar naturally rises and falls throughout the day in response to meals, exercise and other factors. The cornerstone of good diabetes control is maintaining blood sugar within a tight range, to mimic that of people without the disease, but brittle diabetes can make this very difficult. Blood sugar spikes very high or drops too low and not necessarily in sync with the factors that normally affect it. In fact, the blood sugar fluctuations in brittle diabetes are so dramatic that medical attention and frequent hospitalizations are often required. As a result, people with brittle diabetes often experience significant disruption of their daily lives and psychological stress. However, the life expectancy of people with brittle diabetes is no different from those who don’t suffer from the condition. Brittle diabetes is more likely to occur in people with type 1 diabetes mellitus (one percent of people with type 1 diabetes who use insulin have brittle diabetes), but it can be found in some people with type 2. Why does this disease occur? It’s usually because the individual isn’t able to mimic the pancreas’s finely tuned production and release of insulin with the injectable version of the hormone. Additional causes may include diabetic gastroparesis, a condition in which the stomach doesn’t move food down toward the intestines at a normal rate, causing a delay in the delivery of glucose to the cells, and certain endocrine disorders like hypothyroidism. People with brittle diabetes generally have one of the following three presentations: Predominant hyperglycemia (high blood sugar) with r Continue reading >>
Management Strategies For Brittle Diabetes - Sciencedirect
Volume 67, Issue 4 , September 2006, Pages 287-294 Management strategies for brittle diabetesStratgies de prise en charge du diabte instable Author links open overlay panel M.-C.Vantyghem1 Get rights and content Type 1 diabetes is an intrinsically unstable condition. However, the term brittle diabetes is reserved for those cases in which the instability, whatever its cause, results in disruption of life and often recurrent and/or prolonged hospitalization. It affects 3/1000 insulin-dependent diabetic patients, mainly young women. Its prognosis is poor with lower quality of life scores, more microvascular and pregnancy complications and shortened life expectancy. Three forms have been described: recurrent diabetic ketoacidosis, predominant hypoglycemic forms and mixed instability. Main causes of brittleness include malabsorption, certain drugs (alcohol, antipsychotics), defective insulin absorption or degradation, defect of hyperglycemic hormones especially glucocorticoid and glucagon, and above all delayed gastric emptying as a result of autonomic neuropathy. Psychosocial factors are very important and factitious brittleness may lead to a self-perpetuating condition. The assessment of brittle diabetes requires quantification of the variability of blood glucose levels. To quantify instability, measures which have been developed, include Mean Amplitude of the largest Glycemic Excursions (MAGE), Mean Of Daily Differences (MODD), Lability Index (LI), Low Blood Glucose Index (LBGI), Clarke's score, Hyposcore, and continuous blood glucose monitoring. Once psychogenic problems have been excluded, therapeutic strategies require firstly, the treatment of underlying organic causes of the brittleness whenever possible and secondly optimising standard insulin therapy using analogu Continue reading >>
The Outcome Of Brittle Type 1 Diabetes—a 20 Year Study
Aims: To determine the long-term (20 years from presentation) outcome of brittle type 1 diabetes characterized by recurrent episodes of ketoacidosis (DKA). Methods: The cohort studied was a group of brittle diabetic patients from various parts of UK originally identified between 1979 and 1985. Patients were traced, where possible, via their diabetic clinics and/or general practitioners. Data on survival or otherwise were obtained from hospital case notes and information from diabetes care team members. For survivors, clinical and demographic information obtained included complication status and whether they still had brittle characteristics. They were also compared with a matched case–control group of type 1 patients with no history of brittle behaviour. Results: The original cohort comprised 33 patients— all female and mean ± SD, aged 18 ± 5 years and diabetes duration 8 ± 4 years. Thirteen were not traceable and 10 of the remaining 20 (50%) had died during the mean 22 years of follow-up. Deaths occurred evenly throughout the period, and causes were chronic renal failure (3), DKA (3), hypoglycaemia (2), subarachnoid haemorrhage (1) and uncertain (1). Age at death ranged from 27 to 45 years. Of the 10 survivors, none remained brittle, but they had a substantial burden of complications. Compared with the non-brittle control group, there was a significant excess of nephropathy and autonomic neuropathy. Conclusions: We conclude that brittle diabetes characterized by recurrent DKA has high long-term outcome mortality. These deaths were premature and almost all diabetes related. Those who survived had resolution of brittleness, but suffered a significant complication burden. Background: The National Institute for Health and Clinical Excellence (NICE) recently released Continue reading >>
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Brittle Diabetes: Causes, Symptoms, And Treatment Options
The 5 Tests You May Need If Youre a Diabetic This is the ultimate no-nonsense, MD approved guide to get to the root of your blood sugar problem and change the way you live with diabetes. Today were GIVING it away 100% FREE! This ebook, valued at $36.95 is 100% FREE. No credit card required. Your Information is 100% Secure and Will Never Be Shared With Anyone. Copyright 2017 and Beyond. - Privacy Policy Where should we send your FREE Diabetes Recovery Guides? These books, valued at $47 are 100% FREE. No credit card required. Your Information is 100% Secure and Will Never Be Shared With Anyone. Brittle Diabetes: Causes, Symptoms, and Treatment Options Brittle Diabetes: Causes, Symptoms, and Treatment Options If you or a loved one was recently diagnosed with brittle diabetes, you are probably wondering what it is. Not as common as other forms of diabetes, these are the causes, symptoms, and treatment options for brittle diabetes. Brittle diabetes is the term for type 1 diabetes when it reaches a point of instability where it affects your quality of life. If you are diagnosed with brittle diabetes, you can expect many and longer hospitalizations and a shorter life expectancy. Essentially, this condition causes your blood glucose levels to fluctuate wildly and unpredictably. It is uncommon, affecting 3 in 1000 diabetics who are insulin-dependent. It is also more prevalent in young women, than others in the diabetic population. Because one of the hallmarks of brittle diabetes is wildly fluctuating glucose levels, it is also the main symptom to watch out for. Unlike normal glucose level changes that occur in type 1 and type 2 diabetes, brittle diabetes changes without warning and very often. Watch for signs of severely low or high blood sugar levels. One of the most obvious w Continue reading >>
Outcome Of Brittle Type 1 Diabetesa 20 Year Study | Qjm: An International Journal Of Medicine | Oxford Academic
Aims: To determine the long-term (20 years from presentation) outcome of brittle type 1 diabetes characterized by recurrent episodes of ketoacidosis (DKA). Methods: The cohort studied was a group of brittle diabetic patients from various parts of UK originally identified between 1979 and 1985. Patients were traced, where possible, via their diabetic clinics and/or general practitioners. Data on survival or otherwise were obtained from hospital case notes and information from diabetes care team members. For survivors, clinical and demographic information obtained included complication status and whether they still had brittle characteristics. They were also compared with a matched casecontrol group of type 1 patients with no history of brittle behaviour. Results: The original cohort comprised 33 patients all female and mean SD, aged 18 5 years and diabetes duration 8 4 years. Thirteen were not traceable and 10 of the remaining 20 (50%) had died during the mean 22 years of follow-up. Deaths occurred evenly throughout the period, and causes were chronic renal failure (3), DKA (3), hypoglycaemia (2), subarachnoid haemorrhage (1) and uncertain (1). Age at death ranged from 27 to 45 years. Of the 10 survivors, none remained brittle, but they had a substantial burden of complications. Compared with the non-brittle control group, there was a significant excess of nephropathy and autonomic neuropathy. Conclusions: We conclude that brittle diabetes characterized by recurrent DKA has high long-term outcome mortality. These deaths were premature and almost all diabetes related. Those who survived had resolution of brittleness, but suffered a significant complication burden. The term brittle is used to describe an unusual subgroup of type 1 diabetic patients whose lives are disrupt Continue reading >>
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Brittle Diabetes Symptoms And Life Expectancy
Many people are familiar with diabetes. Either they have a family member or close friend with the condition or they themselves have it. However, diabetes is not one condition, rather a collection of metabolic diseases that affect either the way the body uses insulin or the way it makes it. There is not just one kind of diabetes, and there are varying levels of severity as well. One person with diabetes may have mild symptoms and not have to inject insulin, while another may have debilitating symptoms. An extension of this would be brittle diabetes. The term “brittle” used to describe diabetes here refers to a very severe form of the disease. It is characterized by frequent and unpredictable swings of dangerous blood sugar levels where they go from being far too high to being far too low, often without warning. While there is some dispute over how brittle diabetes is classified (some treat it as a subtype others, a complication) it is almost always found in people with diabetes mellitus Type 1. This far less common type of diabetes is often diagnosed during childhood and refers to a physiological problem in the way that the body uses glucose. Unfortunately, brittle diabetes is often a sign that the disease is not being managed properly. This could mean that diet and exercise plans developed with a health care provider need adjustment. It may also signal that a change in diabetes medications is in order. Without the use of medicine combined with healthy diet and lifestyle changes, brittle diabetes is nearly impossible to control. Although advances in modern medicine have made the incidence of brittle diabetes much less common, it is still a rare condition that does occur in some people. There are some risk factors that may increase the likelihood of developing the con Continue reading >>
Management Strategies For Brittle Diabetes.
Abstract Type 1 diabetes is an intrinsically unstable condition. However, the term "brittle diabetes" is reserved for those cases in which the instability, whatever its cause, results in disruption of life and often recurrent and/or prolonged hospitalization. It affects 3/1000 insulin-dependent diabetic patients, mainly young women. Its prognosis is poor with lower quality of life scores, more microvascular and pregnancy complications and shortened life expectancy. Three forms have been described: recurrent diabetic ketoacidosis, predominant hypoglycemic forms and mixed instability. Main causes of brittleness include malabsorption, certain drugs (alcohol, antipsychotics), defective insulin absorption or degradation, defect of hyperglycemic hormones especially glucocorticoid and glucagon, and above all delayed gastric emptying as a result of autonomic neuropathy. Psychosocial factors are very important and factitious brittleness may lead to a self-perpetuating condition. The assessment of brittle diabetes requires quantification of the variability of blood glucose levels. To quantify instability, measures which have been developed, include Mean Amplitude of the largest Glycemic Excursions (MAGE), Mean Of Daily Differences (MODD), Lability Index (LI), Low Blood Glucose Index (LBGI), Clarke's score, Hyposcore, and continuous blood glucose monitoring. Once psychogenic problems have been excluded, therapeutic strategies require firstly, the treatment of underlying organic causes of the brittleness whenever possible and secondly optimising standard insulin therapy using analogues, multiple injections and consideration of Continuous Subcutaneous Insulin Infusion. Alternative approaches may still be needed for the most severely affected patients. Isolated islet transplantation Continue reading >>
Life Expectancy For Type 1 Diabetes May Be Improving
(Reuters Health) - On average, people with type 1 diabetes die 11 to 13 years earlier than people without the condition, according to a new study from Scotland. While the news may be disheartening for people with type 1 diabetes, the study’s senior researcher said the new results are more encouraging than previous estimates that found larger gaps in life expectancies. An important message is that the difference in life expectancy is narrowing, said Dr. Helen Colhoun of the University of Dundee School of Medicine in Scotland. “It’s not zero,” she said. “The goal is to get it to zero.” Among people with type 1 diabetes, formerly known as juvenile diabetes, the body’s immune system destroys insulin-producing cells in the pancreas. Insulin removes sugar from the bloodstream so it can be used for energy. Instead, those people need to inject insulin and pay special attention to their blood sugar – or glucose – levels. Untreated, type 1 diabetes can lead to heart, blood vessel, kidney, eye, and nerve damage. About 29.1 million Americans have diabetes, according to the Centers for Disease Control and Prevention. About 5 percent of those have type 1 diabetes. The researchers write in JAMA that according to earlier data from the U.K., people there with type 1 diabetes died an average of 15 to 20 years earlier than nondiabetics. A 1970s report put the decrease in life expectancy at 27 years for type 1 diabetics in the U.S., and a 1980s report from New Zealand put it at 16.5 years. “They’re mostly very old,” Colhoun said of the estimates. She said the correct information is important, because it shows how far care for type 1 diabetes has come. For the new study, the researchers used national data from Scotland on 24,691 people diagnosed with type 1 diabetes Continue reading >>
Brittle Diabetes (labile Diabetes)
You are here: Home / Types Of Diabetes / Brittle Diabetes (labile diabetes) Brittle diabetes is a sub-type of type 1 diabetes Brittle diabetes mellitus (or labile diabetes) is a term used to describe particularly hard to control type 1 diabetes. Those people who have brittle diabetes will experience frequent, extreme swings in blood glucose levels, causing hyperglycemia or hypoglycemia . HOW DOES BRITTLE DIABETES DEVELOP AND WHAT IS IT ASSOCIATED WITH? Brittle diabetes has a number of potential causes. It can be caused by absorption problems in the intestines. This includes delayed stomach emptying, drug interactions, insulin absorption issues and malfunctioning hormones. Severely low blood sugar levels may also create thyroid and adrenal gland problems. Gastroperesis, delayed stomach emptying, can affect the rate at which food, glucose and insulin is absorbed into the bloodstream. Brittle diabetes is often associated with psychological issues such as stress and depression . IS BRITTLE DIABETES DIFFERENT FROM STABLE DIABETES? All people with diabetes will a certain level of blood glucose level fluctuation. However, when these shifts are not extreme or over-frequent they do not impair the ability to lead a normal life. With brittle diabetes, however, the fluctuations are more serious and tend to result in frequent hospital visits, interruption to employment and can often contribute to psychological issues such as stress. The life expectancy for someone with brittle diabetes is no different to someone who has type 1 or type 2 diabetes . In fact, brittle diabetes can also be described poorly controlledtype 2 diabetes. Brittle diabetes is rare but serious. Around 3 in 1,000 people with type 1 diabetes mellitus will develop brittle diabetes. Those people suffering from psyc Continue reading >>
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Brittle Diabetes (labile Diabetes)
Tweet Brittle diabetes mellitus (or labile diabetes) is a term used to describe particularly hard to control type 1 diabetes. Those people who have brittle diabetes will experience frequent, extreme swings in blood glucose levels, causing hyperglycemia or hypoglycemia. How does brittle diabetes develop and what is it associated with? Brittle diabetes has a number of potential causes. It can be caused by absorption problems in the intestines. This includes delayed stomach emptying, drug interactions, insulin absorption issues and malfunctioning hormones. Severely low blood sugar levels may also create thyroid and adrenal gland problems. Gastroperesis, delayed stomach emptying, can affect the rate at which food, glucose and insulin is absorbed into the bloodstream. Brittle diabetes is often associated with psychological issues such as stress and depression. Is brittle diabetes different from stable diabetes? All people with diabetes will a certain level of blood glucose level fluctuation. However, when these shifts are not extreme or over-frequent they do not impair the ability to lead a normal life. With brittle diabetes, however, the fluctuations are more serious and tend to result in frequent hospital visits, interruption to employment and can often contribute to psychological issues such as stress. Life expectancy with brittle diabetes The life expectancy for someone with brittle diabetes is no different to someone who has type 1 or type 2 diabetes. In fact, brittle diabetes can also be described poorly controlled type 2 diabetes. Is brittle diabetes common? Brittle diabetes is rare but serious. Around 3 in 1,000 people with type 1 diabetes mellitus will develop brittle diabetes. Will I get brittle diabetes? Those people suffering from psychological problems, includin Continue reading >>
- Brittle Type 1 Diabetes OR Type 1 Diabetes – Which is it?
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day
