Brittle diabetes mellitus refers to a rare and severe form of type 1 diabetes mellitus characterized by extreme and unpredictable fluctuations in blood sugar levels. The term "brittle" is used to describe this condition due to the delicate nature of blood sugar control observed in affected individuals. Typically, individuals with brittle diabetes experience frequent episodes of hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar) that may occur multiple times within a day or even over a shorter period.
Brittle diabetes is challenging to manage because conventional diabetes treatments, such as insulin therapy, diet, and exercise, may not effectively stabilize blood sugar levels in affected individuals. The unstable blood sugar levels can lead to a range of symptoms, including excessive thirst, frequent urination, weight loss, fatigue, blurred vision, and difficulty concentrating.
The exact cause of brittle diabetes remains unknown, although it is thought to be a combination of genetic factors, autoimmune response, and psychological stressors. Psychological factors, such as anxiety, depression, and stress, can contribute to the volatility of blood sugar levels in brittle diabetes.
Management of brittle diabetes requires a multidisciplinary approach involving endocrinologists, diabetes educators, psychologists, and dietitians. Intensive insulin therapy and close monitoring of blood sugars are often necessary, including frequent adjustments of insulin dosages based on continuous glucose monitoring (CGM) or frequent blood sugar checks.
In some cases, hospitalization may be required to stabilize blood sugar levels and prevent life-threatening complications. Thus, individuals with brittle diabetes require diligent self-care, ongoing support, and close medical supervision to help prevent the occurrence of severe blood sugar fluctuations.
