Brittle Diabetes

Brittle Diabetes

"BRITTLE"
DIABETES

One of the most prominent features of diabetes is its

uniqueness. No two diabetics respond in exactly the same

way to food, insulin, or exercise, and no two individuals,

even if they show the same test results, will suffer

precisely the same ramifications. The disease is, by

definition, unpredictable. Still, making allowance for

surprises, we know the effects of more insulin, less

insulin, more exercise, less exercise, more food, etc.

For most diabetics, most of the time, the "rules" work.

"If I do this, or do not do that, I can expect this result."

But there is a body of individuals for whom the rules do not

appear to apply, and to them is often applied the adjective

"brittle."

The problem becomes separating the truly "brittle" from

the non-compliant and the poorly-controlled. Some

authorities insist that if all diabetics diligently

practiced "tight control" (as described by the DCCT), none

would be "brittle." They're partially right; the numbers

would go down, but some would remain.

There are some diabetics, practicing tight control,

whose blood glucose level "over-reacts" to minute changes in

diet, exercise, and/or insulin. These individuals

experience unpredictable rises and swoops in blood glucose,

within very short periods, as the result of very small

departures from schedule. Small changes "break" their

control, and they are thus said to be "brittle."

If you are practicing tight control, are in good

compliance with your schedule, and are still experiencing

rapid, out-of- proportion blood glucose changes, talk to

your doctor. You may be "brittle," but your instabilities

may be a sign of some other problem.