My CDE recently told me, that brittle diabetes is not only a generally used description of hard to control T1D (as is mine but I think that's just because I'm really sensitive to... a lot of things), but actually an official term in the International Statistical Classification of Diseases by the WHO...

Please read over here, at my D-blog Pricked Finger in the Pie: My Ice Cream Diabetes

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Comment by acidrock23 on July 29, 2012 at 10:21am

I loathe the term "brittle" as it seems to orient doctors and patients to say "oh well, it's brittle, there's nothing we can do...". Even with the considerable challenges, people should approach it positively and look for solutions instead of being passive.

One solution is the Second Annual Diabetic Ice Cream Social on Facebook!

Comment by Betty J on July 29, 2012 at 3:30pm

I agree withAcidrock23-When I was dxed years ago I was also called brittle by my dr. Fast forward, when given the present day information by an educator which there were none years ago. Anyway, he implied that there was no such type of Diabetes. Since going to an educator in the 1990s I have managed my D very well and have kept it under 7%....as I said I agree/

Comment by Vera J. on July 30, 2012 at 1:40am

I agree with you, that it should not be used be doctors as an excuse for not trying to improve their patients control.

However, as most things, this has two sides: I tend to get very frustrated when things aren't going my way and I feel I don't have control over every single detail - as it happens often with D. I'm well trained, but my body just isn't a machine. Having my D described as brittle helps me to relax and to say: "Well, my body is just very sensitive and it's impossible for me to control everything". It gives me a little more peace of mind and therefore mental health.

And in Germany it also helps you to get your insulin pump payed by your insurance company.

Comment by Holger Schmeken on July 30, 2012 at 3:29am

To me the problem is that people with type 1 diabetes are not one homogenous group. Many long term diabetics without complications have residual beta cells. These beta cells are capable of producing one unit of insulin or even more. This can make a huge difference in the sensitivity to carbs, to the sensitivity to miscalculations of dosages and even the risk of hypos can be reduced. The beta cells can react quickly to lows by reducing their production rate. Thus people in this group see benefits in both directions (high and low). I would not be suprised if the people in the brittle category are just those without any residual beta cells. This makes me wonder if doctors should invest more time to identify the specific subgroup of their patient. Maybe it is possible to give more specific advice with this information at hand.

Comment by acidrock23 on July 30, 2012 at 5:16am

...or maybe "brittle" would have something to do with having more, albeit inconsistent, beta cell function, as it would make it harder to estimate one's BG not being sure how much "home grown" was floating around at any given time?

Comment by Josh F on August 2, 2012 at 6:32pm

Either way, it is what I was always diagnosed with, and I can say for certain, Holgar is right... my system is different than another T1 vs another. Not lack of trying ( after 34 years I got alot of practice) but some days, no matter what I do, the bg is out of whack and VERY sensitive to insulin or carbs. I don't hate the word, as I don't see it as an excuse, nor do I see it as one from my endo... just a way to understand some people are more sensitive than others.

Comment by Vera J. on August 3, 2012 at 9:12am

I don't hate the word either, I think it's just another way of describing my diabetes. Actually, I like the word because of my ice-cream-association. I think that's fun, which was the whole reason for my post. ;-)

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