Brittle Type 1 Diabetes

What is brittle type 1 diabetes?

Brittle diabetes, also called labile or unstable diabetes, is a term used to describe type 1 diabetes that is extremely hard to manage/control. In people with brittle diabetes, their blood sugars frequently fluctuate greatly between hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar). These changes in blood sugar levels can be unpredictable and dangerous. People with brittle diabetes are insulin dependent just like people with normal type 1 diabetes. This is because their pancreas does not produce enough insulin to control blood glucose levels.
Since the fluctuations in blood sugar tend to be severe and unstable, people with brittle diabetes often require frequent hospitalization and continuous self-monitoring of their blood sugar (glucose) levels
Extremely high levels of blood glucose can lead to diabetic ketoacidosis. Since there is not enough insulin in the body to break down the high amounts of glucose in the blood into energy for cells, the body breaks down fat for energy instead. When fat is broken down, ketones are released. These ketones then build up in the blood and make it more acidic. If not promptly treated, diabetic ketoacidosis can lead to coma and even death. 
The main difference between brittle type 1 diabetes and stable type 1 diabetes is that the fluctuations in blood sugar that occur in brittle diabetes are way more frequent, unpredictable, and severe. Brittle diabetes can be very stressful and tends to put a lot of strain on everyday life. 
Risk factors
  • Having type 1 diabetes
  • Gender (brittle diabetes occurs more often in females)
  • Hormonal imbalances
  • Being in your 20s or 30s
  • High stress levels regularly 
  • Not properly managing one’s type 1 diabetes
People who are diagnosed with brittle diabetes are typically diagnosed with type 1 diabetes first. 
Some tests that are done to diagnose type 1 diabetes include:
  • Glycated hemoglobin (A1C) test: This is a blood test that measures your blood sugar level for the last two-three months. It looks at the percent of blood sugar attached to the hemoglobin protein on red blood cells. An A1C level of 6.5% or higher on two different tests means diabetes.
  • Random blood sugar test: This is a blood test that is done to look at your blood sugar levels. A level of over 200 mg/dL typically means diabetes. The doctor will likely look at your medical history and symptoms as well. 
  • Fasting blood sugar test: During this test, a blood sample is taken after the person fasts overnight and blood sugar levels are looked at. Less than 100 mg/dL is normal. 
*To diagnose brittle diabetes your doctor will likely look at your medical history and how your blood sugar levels change overtime by tracking them. Severe, unstable fluctuations in blood sugar levels indicate brittle diabetes* 
The key to treating brittle diabetes is to manage and stable one’s blood glucose levels. The condition itself is not fatal and can typically be managed. Due to severe highs and lows and instability of blood glucose levels, people with this condition often require frequent hospitalization.
Some potential treatments for brittle diabetes include:
  • Subcutaneous insulin pump
  • Continuous glucose monitoring
  • Pancreas transplant (in severe cases)
  • Approximately 3 in 1,000 people with type 1 diabetes will develop brittle diabetes 
  • Brittle diabetes is most common in women in their 20s and 30s 
  • 9.4% of the U.S. population has diabetes 
about brittle type 1 diabetes

  • "Type 1 diabetes." Mayo Clinic. Mayo Foundation for Medical Education and Research, 07 Aug. 2017. Web. 22 Aug. 2017.
  • “Brittle Diabetes (Labile Diabetes).” the global diabetes community., n.d. Web. 22 Aug. 2017.
  • “What is Brittle Diabetes?” Healthline Media. Healthline. 13 Jun. 2017. Web. 22 Aug. 2017.
  • “What is Brittle Diabetes?” Beyond Type 1, 18 Nov. 2016. Web. 22 Aug. 2017.
  • “The adult patient with brittle diabetes mellitus.” UpToDate Inc. UpToDate, 09 May. 2017. Web. 22 Aug. 2017. 
  • “DKA, Hyper/Hypoglycemia.” Diabetes Foundation of Mississippi, n.d. Web. 22 Aug. 2017. 
  • “DKA (Ketoacidosis) & Ketones.” American Diabetes Association, 18 Mar. 2015. Web. 22 Aug. 2017.
  • “National Diabetes Statistic Report, 2017.” Centers for Disease Control and Prevention, n.d. Web. 22 Aug. 2017.  

While there is currently no cure for diabetes, regularly monitoring your glucose levels can help you to take the necessary steps in regulating your blood sugar and live a healthy life. Here are the Top 5 Reasons to Monitor Your Blood Sugar:
top 5 reasons to monitor your blood sugar


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