So I have my Navigator sensor on my arm. I was at the dr office today and the receptionist/ MA/ whatever she is, asked me what it was. I told her, and she asked questions. Then she told me her daughter had been T1 for like 8 years, she is on the pump, and is a brittle diabetic. I had to ask some follow up questions, because I am T1, and have never considered myself to be "brittle".
I started to wonder if there is such a thing as "brittle," or if these are just poor lost souls who are either uneducated, exhaused from this whole thing, or self destructive. I started to feel so bad for her. I wanted to buy this girl who I had never seen "Pumping Insulin" or Think Like a Pancreas.
Is there such a thing as "brittle diabetic", and if so, what does it mean?
I think this is an outdated term for those who haven’t received proper guidance, have ineffectual doctors or have thrown in the towel, as you said.
It’s awful that people get labeled as brittle which tends to mean they’re beyond help from wild BG swings.
I had a nurse tell me I was brittle. When I asked why, her reply was because I tested a lot. Huh? She said that only brittle diabetics had to test frequently. Further evidence to me how little most healthcare people know about diabetes.
My pain management specialist, a really cool guy who is making efforts to treat my spinal stenoisis with streoid injections ( we shall see what the results will be), explained to the nurse attendants that I was wearing a pump because I was a “brittle” diabetic. I had heard him say that before, but never bothered to say anything. yesterday, I did:I sweetelky and calmly told him that I was on a pump as are many type one diabetics, I said that pump trteatment was not just reserved for those with erratic blood sugar swings, but has been i one of stadard trteatments for type one for many years., He really did not know, having really never seen many type ones in his office, and I think I was the only one he had seen on a pump… So "brittle{ is a term from ages ago, when a lot of doctors received, if it was not their specialty, miniscule treatment about diabetes. I remember reading about "brittle’ diabetes in 1970, 2 years after I was first diagnosed at 13. It is an “old-school” term that unfortunately, has lingered around for decades in the medicalkcommunity.
The term “brittle” or “labile” is not really used anymore. It has traditionally referred to the “symptom” in diabetics of large unpredictable blood sugar swings, frequently going hypo or hyper despite “good” efforts to maintain control. As it turns out, many T1s actually retain some low level of insulin production, and this can actually even out your blood sugar control, so early studies had found that T1s with virtually no remaining insulin production were more likely to be “brittle.”
Today, we have learned that there are actually a number of things which contribute to the so called “brittle” blood sugar behavior, ongoing infections, gastroparesis, Addison’s disease, and hypothyroidism. While certainly some people had poor control and have historically been labelled “brittle,” I do think that some of us do have underlying conditions which actually do cause this type of difficult to manage blood sugar control. For some of us, tight control is just much more difficult, but it doesn’t mean that they aren’t doing a heroic job.
I wonder if the medical community has used the term “brittle” to apply to any other person with an affliction outside of diabetics… When I hear the word I think of bones, starfish-like creatures, and also, ironically, candy (e.g. peanut brittle).
There’s that disease where your bones break all the time–I’m blanking on the name. But the people who have it are quite literally brittle. They may have hundreds of bone breaks.
This conversation reminds me of a guy I met when I first moved to Guatemala three years ago, right after I’d been misdiagnosed as type 2. He was also considering moving there but said he was a “brittle diabetic” and he could only find two of the three types of insulin he needed in Guatemala. Reminds me how little I knew back then: I had vaguely heard of brittle diabetics as being very bad ones and was surprisd he needed three types of insulin. Now I don’t believe in brittle diabetics and I’m not sure what he needed three types of insulin for (as opposed to the usual two!) It’s so hard to remember the misconceptions we all had before our own diagnosis! I don’t even know if he was type 1 or 2 and never thought to ask.
I agree that it is an outdated term and the people that are having problems with bouncing blood sugars haven’t had the education to stop them. I started having problems with gastroparesis about the same time I started using Lantus and my BS was bouncing all over the place. When I was in the hospital for a week, the doctor in charge of my BS told me he was baffled. Luckily, I found the DOC, hearing about the book Using Insulin and fixed what I was doing wrong. I don’t think there are very many doctors that teach their patients how to do basal testing – I know I was never told that.
OK, get ready for the different viewpoint. I was pronounced as a brittle diabetic 51 years ago. Never knew or cared what it was; however, an endo a couple of years ago straightened me out, if this is correct.
From what she said, apparently most T1s can have a high BG reading, say 250 or higher and it may take 6-8 hours or a day to get it back to 100 or so. With me if I hit 300 I can have it back to 100 and level within an hour or two.
I don’t know if that is true since I have never polled other T1s on this but I know that I can get the BGs high or low pretty quickly and then have them level them back out.
So I guess I should consider this the “poll”. How long does it take you “non-brittles” (hehehe) to get your BGs under control?
