Brittle Diabetes – It’s all about Control?

brittle diabetesBrittle diabetes occurs in insulin dependent diabetics (typically type 1) whose blood sugar fluctuates greatly and unpredictably. But, what are the symptoms? Often slight deviations from meal, exercise or insulin plans can cause the massive fluctuations. The result is unpredictable cases of hypoglycemia or hyperglycemia.

Many times the result is quite serious including ketoacidosis and even a coma. The condition is extremely rare, occurring in less than 1% people with type 1 diabetes.

There is no definitive cause of the condition. Some researches claim that increased stress or depression can cause hormonal imbalances that lead to the condition. Gastrointestinal problems, drug interactions and insulin absorption issues may also be a cause.

Treatment for the condition varies depending upon the cause. For psychological causes (such as stress or depression), then treatment for the underlying issue is needed. For physical causes, then treatment can be as easy as prescribing an insulin pump to properly regulate the blood sugar. Extreme treatments include several surgical methods, but these tend to be fairly new treatments and have strong risks associated with them.

Misdiagnosed Symptoms

Another problem for doctors is determining whether the diabetic is truly “brittle” or instead is suffering from any number of additional problems. Misdiagnosing the symptoms is very common. Most commonly, some diabetics who have poor diabetes management may be misdiagnosed with the condition. On more rare occasions, the Somogyi effect and the dawn phenomenon may also be providing a false diagnosis.

The Somogyi Effect is your body’s natural attempt to balance itself, in this case balancing its blood sugar levels. The effect of trying to treat the imbalance artificially causes your body to go in a cyclical pattern of up and down blood sugar levels.

The Dawn Phenomenon is your body releasing sugar into the blood stream just before you wake up. The reason for the release is to help you wake up and get started in your day. If you monitor your blood sugar into the morning, sometimes your glucose monitor is registering this effect.


Brittle Diabetes, Peter J. Nebergall, Ph.d., (accessed February 2009).
What is Brittle Diabetes?, Heather M. Ross, (accessed February 2009).
By Erich Schultz – Last Reviewed March 2013.