Brittle Type 1 Diabetes?

[mark4785]

I recently came across a variation of typical type 1 Diabetes named 'Brittle type 1 Diabetes' which is a diagnosis given to people who have issues controlling their blood sugar levels due to insulin absorption problems, hormonal malfunctions, delayed stomach emptying (gastroperesis) or drug interactions.

I feel I may meet the definition of this form of Diabetes because I have trouble lowering my blood sugar levels using my Novorapid insulin up to 4 hours after waking. After about 4 hours the insulin I've administered to lower the blood sugar level throughout the morning period will take effect all in one go and can cause very low hypoglycemia to occur.

A typical waking day occurs like so with the following b/s levels in mmol:
7:00 am (just woke up): 4.5-5.5
8:00 am (eating breakfast): 4.5-5.5
9:00 am (arrived at college): 7.0
10:00 am (near end of first lesson): 12.0-14.0
11:00 am (home; exercising more): 11.0
12:00 pm: (home): 6.5
1:00 pm (home): 2.6

I never used to have this progressively highering b/s level for approx. 4 hours when I was administering Mixtard 30 insulin around 3 years ago and so I theorised that the Novorapid that I now use is playing some role in the rising blood sugar. I came to this conclusion because I was diagnosed with 'stress induced type 1 diabetes' (official diagnosis) and so adrenaline must play some role in lowered insulin production and utilisation. I felt that Novorapids' function was being inhibited by my high adrenaline levels.

However, since coming across the term brittle diabetes, which seemingly can have many causes, I'm not so sure the insulin in the route cause and feel that even if I reverted back to Mixtard 30 (an insulin that is soon to disappear) I'd still have issues with uncontrollable b/s levels in a morning. I know for sure that my b/s levels are uncontrollable during the morning period because when I first started experiencing the problem of highering b/s levels about 2 years ago, I clearly remember setting my insulin pump to give up to 5.0 units of basal Novorapid insulin per hour via my Insulin pupm and the insulin did not work to lower my b/s levels until the end of the 4 (approx.) hour period. Of course, at the end of the 4 hour period I'd have extreme hypoglycemia that my blood glucose meter could only describe has 'LO'.

So do I have this form of diabetes and is there a solution to the problem it presents?

Thanks,

Mark.

 

[Geri]

Hi Mark, brittle diabetes, as you know, comes with a variety of symptoms. More imformation would be needed for anyone, medical staff included, to state whether this and other symptoms mean that you have brittle diabetes.
You do however, on the list and times of readings, show that you have a sudden drop of bs around and about the time when the actrapid is peaking. (this is aaround 4 hrs after injecting).
Are you giving yourself a correction dose? If you are then I would stop this as this would obiously add to the low bs.
OK, another thing that struck me was that you are attending college. Are you drinking coffee from the drinks machine? Even unsweetened coffee from these machines makes my blood sugar rise to about 17, quite quickly too. Its just a suggestion, but also check any bottled water for added sugars or fruit sugars?
I would like to suggest more to help but feel that you need to speak to a diabetes nurse first.
However, I wouldnt consider that you have brittle diabetes just on the information given. Please let us know how you get on?