Presentation
Diagnosis and management of this potentially lethal condition present significant challenges, as was shown in several cases Dr. Hirsch presented at a meeting sponsored by the American Diabetes Association. [mdedge.com]
DISCLAIMER The information presented in this activity represents the opinion of the faculty and is not necessarily the official position of the Endocrine Society. [education.endocrine.org]
At present, BDF lists 18 known causes of brittleness. Unlike type 1 diabetes, brittleness leads to a highly disruptive daily life for those who suffer from this rare disease. [change.org]
Unstable and Brittle Diabetes: Past and Present 2. An Overview of Brittle Diabetes 3. The Syndrome of Recurrent Diabetic Ketoacidosis 4. Insulin Resistance in Diabetes 5. [bookdepository.com]
NOTOC A *Acanthosis nigricans A brown to black, poorly defined, velvety hyperpigmentation of the skin, usually present in the posterior and lateral folds of the neck, the axilla, groin,… … Wikipedia Glossary of diabetes — See also: Diabetes (disambiguation [medizin.deacademic.com]
Entire Body System
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Turkish
In other languages: French Italian Portuguese Romanian German Dutch Swedish Russian Polish Czech Greek Turkish Chinese Japanese Korean Arabic [wordreference.com]
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Asymptomatic
"The most frequent cause [of glucose fluctuation] nowadays is the presence of asymptomatic hypoglycemia that leads to a hyperglycemic rebound," said Freddy Eliaschewitz, MD, a diabetologist with Albert Einstein Hospital in São Paulo, Brazil. [medpagetoday.com]
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Weight Loss
A further concern to keep in mind with a patient such as this is that between one-third and one-half of all teenage girls with type 1 diabetes will withhold insulin at some time for weight loss. [mdedge.com]
Gastrointestinal
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Abdominal Pain
It can cause: Breath that smells fruity Nausea and vomiting Shortness of breath Weakness Confusion Abdominal pain Coma Who Gets It? Brittle diabetes isn't common. About 3 out of every 1,000 people who take insulin for diabetes will get it. [webmd.com]
Liver, Gall & Pancreas
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Hepatomegaly
Rare causes • Mauriac syndrome:It is rare complication of type 1 DM characterized by extreme hepatomegaly due to glycogen deposition,along with growth failure and delayed puberty. • Polyglandular autoimmune syndrome 6 7. [de.slideshare.net]
22 Brittle diabetes revisited: a description of erratic and difficult-to-control diabetes in an elderly woman with Type 1 diabetes. 38 Newman C...Dinneen SF 31004371 2019 23 Diabetes of the exocrine pancreas. 38 Wynne K...Dornhorst A 30151918 2019 24 Hepatomegaly [malacards.org]
Eyes
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Blurred Vision
[…] will likely include: Frequent urination Extreme thirst Blurred vision Fatigue Headache If you don’t treat high blood sugar, it can turn into a more serious condition called ketoacidosis. [webmd.com]
vision dry skin Balancing your blood sugar levels is the primary way to manage this condition. [healthline.com]
Musculoskeletal
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Osteoporosis
A diagnostic work-up determined that she had underlying celiac disease, with an important clue being the osteoporosis. “When you see osteoporosis in a young person you have to think about calcium absorption,” he said. [mdedge.com]
Neurologic
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Neglect
Diabetes in the elderly–a neglected area? Diabetologia 1984 ; 27: 167 – 73 Google Scholar Medline 16. Meneilly, G.S., Tessier, D. Diabetes in the elderly. Diab Med 1995 ; 12: 949 – 60 Google Scholar Crossref Medline 17. [journals.sagepub.com]
In some cases, psychological problems lead to neglected self-care for diabetes. For example, people with brittle diabetes may stop maintaining a healthy diet or keeping up with the management of their blood sugar. [verywellhealth.com]
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Seizure
Symptoms can include: Feeling shaky Nervousness or anxiety Sweating, chills Irritability Confusion Fast heart rate Dizziness Nausea Blurred vision Weakness Headache Seizures Unconsciousness When your blood sugar shoots up above 200 mg/dl, your symptoms [webmd.com]
Severely low blood sugar, called hypoglycemia, can cause sudden and unexpected seizures, coma, heart attacks, and even death. advertisement Insulin is made by specialized cells in the pancreas called islet cells. [statnews.com]
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Behavior Problem
Memory or behavioral problems were rare, and only four patients were considered as possibly deliberately manipulating therapy. However, 84 percent of these patients were living independently. [docguide.com]
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Tremor
At 6 months following islet allotransplantation, he reported restoration of hypoglycemia awareness, with symptoms of tremors and hunger occurring during one episode of hypoglycemia when the capillary blood glucose was 3.4 mmol/L. [pancreas.imedpub.com]
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Slurred Speech
This disruption caused by symptoms including loss of cognitive functioning and slurred speech, is a key defining feature that separates BT1D from stable Type 1 Diabetes (T1D). [prnewswire.com]
Workup
Urine
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Glycosuria
Extract: Hormonal balance was studied in eight insulin-treated diabetic children who had excessive glycosuria. Glucose, growth hormone, and cortisol in plasma were determined every 0.5 hr for 48 hr. [nature.com]
Other Pathologies
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Pancreatic Necrosis
For example, cases with extensive pancreatic necrosis (as in this case), severe pancreatic trauma, or where there is concern or evidence of pancreatic sepsis (because of a risk for hepatic abscesses). [pancreas.imedpub.com]
Treatment
If psychological issues are behind brittleness, treatment with medication or counseling may help iron out things. [diabetesforecast.org]
That makes sense, because insulin is the main treatment for this common disease. But it isn’t a cure. [statnews.com]
BT1D defies all modes of standard treatment applied to stable T1D patients. 2. Blood glucose levels are unstable, uncontrollable and unpredictable not “harder to control”. 3. [bdtype1.com]
and close monitoring of treatment success through specific parameters." [medpagetoday.com]
TREATMENT options • Lifestyle and education • Psychotherapy • Alternative medicine • Insulin therapy • Insulin pump therapy • Islet transplantation 13 14. [de.slideshare.net]
Etiology
ETIOLOGY • Psychological[most comon] • Nonphysiologic matching of meals,exercise and insulin • Poor adherence /compliance to treatment • Chronic infections • Chronic medical illness • Endocrinopathies • -Recurrent Ketoacidosis 1]Acromegaly 4 5. • -Recurrent [de.slideshare.net]
Prevention
Working with your doctor, you can learn to manage — or prevent — brittle diabetes. [healthline.com]
38 Johnson CN...Adams DB 24308511 2014 50 Results of open and robot-assisted pancreatectomies with autologous islet transplantations: treating chronic pancreatitis and preventing surgically induced diabetes. 38 Gruessner RW...Rilo H 25131087 2014 [malacards.org]
The intent of this disclosure is not to prevent CME planners with relevant financial relationships from planning or delivery of content, but rather to provide learners with information that allows them to make their own judgments of whether these financial [education.endocrine.org]
Fortunately, treatment advances allowing continuous glucose monitoring and more responsive delivery of insulin have greatly improved the ability to control blood sugar and have helped prevent complications and deaths from Type 1 diabetes. [ Read: Differences [news.yahoo.com]
The short diabetes duration in our case provides an opportunity for primary prevention of microvascular complications. [pancreas.imedpub.com]