Signs of Brittle Diabetes and When to Contact a Doctor

Medically Reviewed By Kelly Wood, MD
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Brittle diabetes is characterized by large fluctuations in blood sugar levels. With proper treatment, it is typically able to be stabilized. Brittle diabetes, or labile diabetes, refers to cases of diabetes with large fluctuations in blood sugar levels. These changes are unexpected and can be severe, making it difficult to manage the condition.

In most cases, brittle diabetes can be stabilized. Without proper treatment, however, it can lead to severe complications. Proper management of your blood sugar levels is important to treat and prevent brittle diabetes. 

This article explores what it means to have brittle diabetes, risk factors, and symptoms, as well as treatment options, outlook, and strategies for prevention. 

What it means to have brittle diabetes

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People with brittle diabetes experience frequent and drastic changes in their blood sugar levels. During these fluctuations, blood sugar levels can quickly go from too low (hypoglycemia) to too high (hyperglycemia), or vice versa.

Though uncommon, brittle diabetes can be difficult to manage and can affect your quality of life. The sizable changes in blood sugar levels are potentially dangerous and can lead to frequent hospitalizations. 

Risk factors for brittle diabetes

According to the Genetic and Rare Diseases Information Center, people with type 1 diabetes have the greatest risk of developing brittle diabetes. However, in rare cases, people with type 2 diabetes may also develop it.

These frequent changes in blood sugar levels are sometimes triggered by a variety of factors.

Examples of risk factors for brittle diabetes include: 

Signs and symptoms of brittle diabetes 

The symptoms of brittle diabetes resemble those of low blood sugar levels and high blood sugar levels. However, in people with brittle diabetes, the symptoms may change quickly from one category to the other. 

According to the Centers for Disease Control and Prevention (CDC), some common symptoms of high blood sugar levels include: 

Some common symptoms of low blood sugar levels include:

In extreme cases known as hypoglycemia unawareness, you may not experience any symptoms during a period of low blood sugar. This can allow your blood sugar levels to drop dangerously low without being noticed, which can result in a loss of consciousness, seizure, or death.  

If any of these signs or symptoms accompany your diabetes, it is important to talk with your doctor or endocrinologist. They will evaluate your blood sugar levels over time to give you a diagnosis and recommend treatment options.

Learn about 12 things your diabetes doctor wants you to know here.

Treatment of brittle diabetes 

Although there is currently no cure for diabetes, it is possible to stabilize brittle diabetes with proper treatment and management.

Treatment for brittle diabetes focuses on stabilizing your blood sugar levels with proper insulin levels. That said, the specific treatment will vary depending on the cause of your changes, which will vary from person to person. 

Your doctor may recommend one of the following treatment options to manage your brittle diabetes:

  • Insulin pumps: These are small devices that deliver insulin as a steady, continuous dose or as a single dose at your direction, generally at mealtimes. 
  • Continuous glucose monitors (CGMs): CGMs use a tiny sensor inserted beneath the skin to continuously monitor the blood sugar in the fluid inside your body. The monitor will sound an alarm if your blood sugar levels become too high or too low. 
  • Pancreas transplants: These are surgical procedures to implant a healthy pancreas from a donor into a person whose pancreas no longer functions properly. Pancreas transplants are less common than other treatment options and are generally reserved for people with type 1 diabetes.
  • Specialized therapies: These may be treatment options for people whose brittle diabetes is triggered by emotional stress, an eating disorder, or depression

Work with your doctor to determine which factors could be contributing to your brittle diabetes. They will help you determine the right treatment to reduce the frequency and severity of the changes in your blood sugar levels. 

Learn more about blood sugar and diabetes here.

Outlook for brittle diabetes

Brittle diabetes itself is not life threatening. However, it can lead to complications that may affect your quality of life, lead to frequent hospitalizations, and shorten your life expectancy. 

Possible complications of brittle diabetes include:

  • Cardiovascular disease (CVD): CVD refers to a group of diseases that affect the heart and blood vessels. When blood sugar levels become high, it can damage the blood vessels and the nerves that control the heart. This increases your risk of a CVD, such as heart disease. Heart disease is the leading cause of death for people with diabetes.
  • Diabetic retinopathy: This is due to high blood sugar levels. It is an eye condition that damages the blood vessels in the retina. It can ultimately lead to vision loss and blindness. 
  • Kidney disease: This is also known as nephropathy and is the result of the damage to the kidneys when blood sugar levels are high. Without an early diagnosis, it can result in end stage renal disease. 
  • Diabetic ketoacidosis (DKA): DKA is a life threatening complication of diabetes in which the body uses fat for fuel due to not having enough insulin for the body to use blood sugar for energy. The process of breaking down the fat produces acids, or ketones, which can build up in the body and cause severe complications, including death.
  • Diabetes distress: This refers to the emotional response that some people experience as a result of living with diabetes. It can make it difficult to properly manage your diabetes and may lead to worse outcomes. 

Most cases of brittle diabetes are treatable. However, prevention is the best way to reduce the risk of developing complications. 

Prevention of brittle diabetes

Although brittle diabetes is rare, it can be serious. It is important to take steps to prevent yourself from developing the condition, which you can do by properly monitoring and managing your blood sugar levels. 

Your doctor may make recommendations to help you manage your diabetes and prevent it from turning brittle, including:

  • consuming a healthy diet
  • maintaining a moderate weight
  • incorporating regular exercise into your routine
  • managing your stress levels
  • regularly monitoring your blood sugar levels

If you are having difficulty managing your diabetes or are experiencing large, sudden fluctuations in your blood sugar levels, discuss your options with your doctor. They can help determine the cause of your brittle diabetes. They can also develop a treatment plan to help stabilize your blood sugar levels and reduce the frequency of these fluctuations. 


Brittle diabetes is a rare condition that is characterized by sudden, drastic changes in blood sugar levels. During these fluctuations, your blood sugar level may quickly go from one extreme to another — from low to high or from high to low.

People with type 1 diabetes have the highest risk of developing brittle diabetes, but people with type 2 diabetes can also develop it in some cases.

Brittle diabetes is serious, and it can significantly affect your quality of life. In some cases, it can result in frequent hospitalizations or lead to complications that may ultimately result in death. 

In most cases, brittle diabetes is preventable and able to be stabilized with proper control of your blood sugar levels. If you are experiencing large fluctuations in your blood sugar levels, it is important to talk with your doctor. They will help determine the underlying cause and recommend suitable treatment options.

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Medical Reviewer: Kelly Wood, MD
Last Review Date: 2022 Mar 21
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