Is your diabetes difficult to control? Let's talk about 'Brittle Diabetes'!

Are you someone who is being treated for diabetes? So, do you sometimes feel like your blood sugar level suddenly drops so low that you feel like you're going to faint? Or have you ever felt like it's getting too high? Doctors call this type of diabetes, which is very difficult to control and unstable, "Brittle Diabetes." It's also called "Labile Diabetes." "Brittle" or "Labile" both mean "easily changing" or "unstable."

Simply put, what is 'Brittle Diabetes'?

Simply put, 'Brittle Diabetes' is when your blood glucose levels frequently change rapidly from very low levels (which we call (Hypoglycemia)') to very high levels (which we call (Hyperglycemia)').

The important thing is that this is not a new type of diabetes. We consider it a complication or sub-condition of diabetes, usually associated with Type 1 Diabetes.

Why is this happening? What are the reasons for this?

In fact, any diabetes condition can become unstable if not managed properly. Therefore, it is a bit complicated to accurately diagnose 'Brittle Diabetes'. There can be several reasons why your sugar levels can fluctuate so drastically.

Think about whether these things affect you too:

• Skipping medications and tests: Do you take your medications exactly as prescribed by your doctor? Do you check your glucose levels several times a day? If you skip these, it could be a major cause.
• Severe stress: Things like extreme stress, anger, and sadness directly affect our body's hormones and disrupt sugar levels.
• Eating Disorders: Conditions such as eating excessively, not eating properly, or eating too much at once.
• Nutritional problems: The intestines do not properly absorb the nutrients in the food you eat. Examples of this include conditions like Celiac Disease.
• Stomach problems: Gastroparesis is a condition in which the movement of food from the stomach to the intestines is very slow, or sometimes stops. This can have a major impact on insulin function.
• Insulin sensitivity: Some people are very sensitive to insulin, and even a small amount can cause a sudden drop in blood sugar.

Often, one or more of these factors can contribute to this. In some cases, even doctors cannot find a specific cause.

How is this condition diagnosed? What are the symptoms?

Symptoms vary depending on whether your blood sugar levels are high or low. Let's look at these symptoms separately.

Be careful! High blood sugar can be dangerous (Ketoacidosis)

If you don't treat high blood sugar (hyperglycemia) quickly, it can turn into a very dangerous condition called ketoacidosis . This is when the body can't use glucose for energy, and starts burning fat instead. As a result, toxic chemicals called ketones build up in the blood and urine. This is a medical emergency.

Symptoms of Ketoacidosis:

• A fruity smell on the breath
• Nausea and vomiting
• Difficulty breathing
• Severe weakness
• Loss of consciousness
• Stomach ache
• Falling into a coma

If you have any of these symptoms, go to a hospital's Emergency Department (ETU) immediately, without delay. This is a serious condition that can even be life-threatening.

Who is more likely to develop this condition?

Brittle diabetes is not a very common condition. It affects about 3 in 1,000 people with diabetes who use insulin. Although it can affect people of any age, it is slightly more common in women than in men.

Another important thing is that if you have frequent hypoglycemic episodes, you are at a slightly higher risk. Because when your blood sugar drops too low, over time your body's ability to detect it decreases. Then each time your blood sugar drops, it can get worse, leading to 'brittle diabetes'.

How do you live with this? What are the treatments?

This condition can really disrupt your daily life. Because you can't predict when your blood sugar will drop or rise. You may have to go to the hospital frequently, which can make it difficult to work or do household chores. It can even be life-threatening.

When treating you, your doctor will first focus on your immediate needs for your blood sugar levels. Then, they will create a plan to closely manage your diabetes. Fortunately, today's new technology and treatments can help you manage this condition.

You may be prescribed treatments such as:

• Continuous Glucose Monitor (CGM): This is a small device with a sensor that is placed under or on the skin. It continuously measures your blood sugar level and sounds an alarm if it gets dangerously low or high.
• An insulin pump: This is also a small machine that you wear throughout the day. It automatically releases insulin into the body at the right time and in the right amount. This helps to keep blood sugar levels stable.
• Pancreatic Transplant Surgery: This is a very complex surgery. In this, a healthy pancreas from a deceased donor is transplanted into the body to re-stimulate insulin production.

Your doctor will determine the best treatment for you. He or she will determine the cause of your condition. Once you have a treatment plan, you have a big responsibility to make it a success.

• Exercise regularly.
• Follow the nutritional advice given to you exactly as it is.
• Never miss medication times or doses.
• Above all, stay in touch with your diabetes doctor and medical team. Get the medical and emotional support you need from them.