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What is Brittle Diabetes?



  1. “Brittle” describes a severe form of diabetes. It occurs when blood sugar levels go up and down.
  2. Dizziness and weakness are common symptoms.
  3. Balancing blood sugar is the primary treatment for this condition.

“Brittle” describes a severe form of diabetes. It’s characterized by an up and down of blood sugar levels. These swings in glucose can affect quality of life and even lead to hospitalization. Advances in diabetes management have made this condition uncommon, but brittle diabetes is still a concern among diabetics. It’s also a sign that your blood sugar is poorly managed. The best way to prevent brittle diabetes is to follow a health plan set forth by your doctor.

Brittle diabetes: Outdated term or neglected condition? »

Risk factors

Brittle diabetes is almost exclusive to type 1 diabetes. This doesn’t mean all type 1 diabetics will develop this health complication, and people with type 2 diabetes aren’t immune. Some doctors classify it as a complication of diabetes, while others consider it a subtype of type 1 diabetes.

Brittle diabetes causes your blood sugar to spike and drop at rapid rates. While type 1 diabetes is characterized by elevated blood sugar levels (hyperglycemia), your body may have a reaction to insulin and cause low glucose dips. This results in a dangerous "roller coaster" effect. The fluctuation in glucose can be rapid and unpredictable, causing dramatic symptoms. You may be at an increased risk for brittle diabetes if you:

  • are female
  • have hormonal imbalances
  • are overweight
  • have hypothyroidism (low thyroid)
  • are in your 20s or 30s
  • endure a high level of stress on a regular basis
  • have depression


Hypo- and hyperglycemic symptoms are common signs of brittle diabetes due to fluctuations in blood sugar. Extremely low blood sugar can cause:

  • dizziness
  • weakness
  • irritability
  • extreme hunger
  • trembling hands
  • double vision
  • severe headaches
  • sleeping difficulties

Symptoms of high blood glucose in brittle diabetes can include:

  • weakness
  • increased thirst and subsequent urination
  • vision changes
  • dry skin

People with diabetes experience these symptoms when blood sugar levels are occasionally off. The difference is that brittle diabetes creates frequent changes in these symptoms without warning.


Balancing blood sugar is the primary treatment for this condition. Due to the ups and downs of glucose, you may not respond to insulin the way you should. Subcutaneous insulin pumps are the most effective tool for controlling brittle diabetes. Still, you need to monitor your blood sugar frequently to make sure it doesn’t get too high.

Some people with brittle diabetes still experience blood sugar fluctuations despite treatment. In severe cases, a pancreas transplant may be required. But this is rare because brittle diabetes often responds positively to changes in treatment.


Advances in type 1 diabetes treatment have decreased the incidence of brittle diabetes. While this condition isn’t very common in diabetics, it’s important to take preventive measures against it. This is especially the case if you have certain risk factors. Your doctor might recommend that you:

  • maintain a healthy weight
  • see a therapist to manage stress
  • obtain general diabetes education
  • see an endocrinologist (who specializes in diabetes and hormonal imbalances)


Brittle diabetes is a rare complication. But you should be aware of the possible causes and symptoms. Monitoring and managing your blood sugar is the best way to prevent all diabetic complications. This includes brittle diabetes. The American Diabetes Association advocates for prevention and treatment over labeling diabetics as “brittle.”

Brittle diabetes itself is not fatal. Severe changes in blood sugar can lead to hospitalization due to the possibility of diabetic coma. Over time, this condition can lead to other complications like:

  • thyroid disease
  • adrenal gland problems
  • depression
  • weight gain