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Question:

Could you describe to me what a "Brittle Diabetic" is?

Answer:

Brittle diabetic is a term that continues in occasional use, but is really out of date. Why? Historically, the "brittle diabetic" had blood sugars that were alternately very high and very low. The patient felt that if he/she took insulin for the highs a low would follow. Patients could not predict whether the diabetes would by okay, high or low. A hypo would seem to just jump out of the woodwork. The patient would just give up and declare "I'm brittle."

Now it should be clear that we have the tools to manage diabetes. Better insulins, better delivery systems, better monitoring systems, and maybe even smarter doctors, educators and patients. We all understand a bit better the relationships of insulin to diet (carbs) and exercise.

My experience suggests that nowadays the brittle diabetic is one who is unwilling/unable to commit to the necessary care for diabetes.

LD

Additional comments from Linda Mackowiak, diabetes nurse specialist:

As Dr. Deeb stated, "brittle" is not a word currently used to describe diabetes, except in cases of severe psychological/ social distress interfering with diabetes control. Type 1 diabetes is, by nature, "brittle." Everyone has difficult periods, but most people can prevent hospitalizations for diabetic ketoacidosis and frequent severe hypoglycemia.

LM

Original posting 9 Jul 1998
Posted to Daily Care

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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