What is brittle diabetes?
We often hear about Type 1 and Type 2 diabetes due to intensive research needed to help juveniles recover and due to the apparent weight epidemic in North America. And due to increasing awareness regarding pregnancy health issues we are learning more about Gestational Diabetes. But have you heard much about brittle diabetes, also called Labile Diabetes?
Brittle Diabetes is a particularly challenging form of uncontrolled Type-1 diabetes that results in extremely high blood sugar and extremely low blood sugar, with dramatic swings back and forth. Patients who suffer from labile diabetes tend to spend long periods of time, weeks even, in the hospital to stabilize their blood sugar.
Other medical conditions are often related to brittle diabetes. Gastrointestinal problems may develop due to delayed stomach emptying, which in turn can cause drug interactions, problems with insulin absorption and hormonal malfunction. This GI condition is referred to as Gastroperesis. Reglan is the medication that helps with this condition to help the stomach empty properly.
There are also significant psychological effects such as depression and stress related to the up and down swing between hypo- and hyper- glycemia. The depression in turn causes the depressed person to ignore their very fragile health and need for balanced health care, which causes the blood sugar pendulum to swing. Symptoms of depression and stress are more common among women than men, and more likely among overweight women ages 15 to 30.
The path toward treatment is as much about the physiological aspects as it is along the psychological. Blood tests can help ascertain the causes of the swings. The test will examine how the glucose responds when the drugs are used properly in a controlled environment. If the patient’s body responds well, the condition is more likely related to emotional and mental health than physiological health.
In the case of physiological causes a specialty team will work together while the patient is hospitalized; usually for several weeks. The treatment will involve intensive monitoring of food, glucose, and insulin to help stabilize the pendulum. In some cases continuous insulin pumps are put in place. In quite severe cases where the patient does not appear to respond well to other medications, islet transplants are used to help the patient, whereby beta cells from a donor are transferred to the recipient’s body. The patient will have to learn to stay on the medications to fight immunity issues and anti-rejection drugs for the rest of her life.
Along with physical help, the patient will get psychological help to learn how do deal better with stressors. Psychotherapy is used to help them learn the root causes of their depression and emotional responses and then the learn how to change the way they think of things via behavioral modification.
Brittle Diabetes is nothing to treat lightly. The mighty pendulum that swings from dangerous highs to dangerous lows can result in other serious illnesses that can leave a person with a very low quality of life. Take care of your body so it can take care of you.