What causes huge swings in blood sugar?
Learn the 14 causes of huge swings in blood sugar and brittle diabetes here.

In most cases, the etiology of brittle diabetes may be traced back to diabetic neuropathy, which causes inconsistency in glucose digestion and absorption due to autonomic system damage.

  • Some psychological problems have been linked to an increased chance of developing brittle diabetes. Depression and stress are two psychological issues associated with the illness. Stress might cause transient insulin resistance, which could explain the sharp fluctuations in glucose levels.
  • A history of trauma may trigger huge swings in blood sugar due to pro-inflammatory markers released in response to inflammation.
  • Post COVID-19 syndrome may manifest as persistently high sugar levels in previously well-controlled sugar levels in people with diabetes. This may be due to tissue inflammation and the use of steroids during the management of COVID-19.

Brittle diabetes is characterized by large swings in blood glucose levels, resulting in erratic hyperglycemia or hypoglycemia. Even if the patient takes their recommended medication, this kind of diabetes is extremely difficult to control.

When insulin levels go very low, the patient may develop huge swings in blood sugar levels leading to brittle diabetes. This happens because there is not enough natural insulin to aid with blood glucose swings. The condition becomes harder to regulate and maintain in patients with brittle diabetes. Predicting instances of such variance is thought to be difficult.

14 common causes of huge swings in blood sugar or brittle diabetes

  1. Sleep disturbances
  2. Emotional disturbances
  3. Infections, such as the common cold
  4. Dehydration
  5. Hormonal fluctuation during periods and menopause
  6. Emotional or physical stress
  7. Oral contraceptives
  8. Drinks, such as tea, coffee, and energy drinks
  9. Medications, such as steroids, diuretics, and antidepressants
  10. Long-distance travel (change in time range)
  11. Excessive physical activity
  12. Alcohol
  13. Seasonal changes
  14. Artificial sweeteners

What causes brittle diabetes?

Brittle diabetes may be caused by poor glycemic control, which can result from any of the following factors:

  • 5 factors that may cause huge swings in blood sugar or brittle diabetes:
    1. Not taking medications as prescribed (noncompliance)
    2. A condition called “gastroparesis” or slow emptying of the stomach may lead to reduced insulin absorption into the bloodstream
    3. Intestinal malabsorption
    4. Celiac disease
    5. Increased sensitivity to insulin
  • 3 common risk factors for brittle diabetes include:
    1. Type I diabetes, (non-compliance with treatment, poor glycemic control, female gender), the most common cause
    2. Prolonged type II diabetes (with the above factors)
    3. In most cases, the disease manifests itself at an earlier age, hence being 40 years old or younger appears to be another risk factor

A risk factor enhances one's chances of developing a condition compared to someone who does not have the risk factors. Certain risk factors are more significant than others. Furthermore, the absence of a risk factor does not rule out the possibility of developing the illness. It is always a good idea to talk to the doctor about the impact of risk factors.

SLIDESHOW

Diabetes: What Raises and Lowers Your Blood Sugar Level? See Slideshow

How can I know if I have brittle diabetes?

If a person’s blood sugar levels drop too frequently or are too high to control, they may have brittle diabetes instead of uncontrolled diabetes. It can negatively impact the patient's quality of life. In such cases, the patient may require periodic hospitalizations to regulate these variations.

Signs of brittle diabetes are frequently misinterpreted as signs of uncontrolled diabetes. However, one should consult their doctor if they notice any of the listed symptoms regularly.

19 signs and symptoms of brittle diabetes include:

  1. Frequent fluctuations in blood sugar levels without any specific reason
  2. Experiencing other complications, such as ketoacidosis (which requires hospitalization)
  3. Dizziness and weakness all the time
  4. Increased thirst
  5. Increases urination
  6. Frequent episodes of nausea and vomiting
  7. Increases hunger
  8. Irritability (feelings of anger or frustration)
  9. Anxiety
  10. Dry skin
  11. Involuntary trembling hands
  12. Severe headaches
  13. Sleeping difficulty
  14. Changes in vision, such as double vision or blurred vision
  15. Sweet, pungent breath
  16. Deep or fast breathing
  17. Delayed gastric emptying
  18. Severe headaches
  19. Extreme fluctuating blood sugar levels can cause a lot of emotional disturbance, such as depression, confusion, and lack of energy

How is brittle diabetes diagnosed?

Depending on the symptoms, doctors may diagnose brittle diabetes based on the following examinations:

  • Complete physical examination
  • Thorough medical history evaluation
  • Assessment of signs and symptoms
  • Laboratory tests
  • Imaging studies
  • Biopsy studies if necessary

Many clinical disorders can have symptoms that are similar to one another. To arrive at a definitive diagnosis, the doctor may conduct additional tests to rule out other clinical disorders.

What are the treatment options for brittle diabetes?

The patient will be treated based on the underlying physiological or psychological cause. Hospitalization will be required to monitor the patient's diet, insulin levels, and mental condition. Medication will be delivered under the supervision of a doctor.

Brittle diabetes treatment options may include:

  • Ensuring affected people's compliance to achieve optimal glycemic control
  • Identifying and correcting preexisting problems in diabetics that can contribute to brittle diabetes
  • Techniques to deal with stress and low mood
  • Hospitalizations for blood glucose control

A study is underway to investigate the prospects for treating and preventing illnesses, such as brittle diabetes. Some newer therapeutic approaches have been proposed. In 2016, the U.S. Food and Drug Administration authorized an artificial pancreas. There is the option of undergoing islet cell transplantation surgery, but it is still in the early stages.

Doctors mostly approach treatment in the same way that they would with traditional diabetes, with customization in meals and insulin doses. Glucose monitoring and insulin pumps are potential therapies to help manage brittle diabetic symptoms.

How can you prevent brittle diabetes?

In some cases, brittle diabetes may be prevented by considering the following factors:

  • To maintain a low glycemic index, adhere to a treatment plan
  • Exercise regularly
  • Avoid exercise on an empty stomach
  • Mealtime punctuality (small meals at regular intervals, without lengthy gaps between large meals)
  • Mealtimes should be free of processed carbohydrate products
  • Limiting intake of alcohol and caffeine
  • Seeking quick medical intervention for diseases that may predispose an individual to brittle diabetes
  • Routine medical screening including tests and physical examinations at regular intervals
  • Meditation and stress management

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Medically Reviewed on 4/22/2022
References
Image Source: iStock image

Cleveland Clinic. Brittle Diabetes. https://my.clevelandclinic.org/health/diseases/21499-brittle-diabetes#

National Institutes of Health. Brittle diabetes. https://rarediseases.info.nih.gov/diseases/11900/brittle-diabetes

Snouffer E. Is brittle diabetes for real? https://diabetesvoice.org/en/diabetes-views/is-brittle-diabetes-for-real/