Jewels Doskicz is a registered nurse, freelance writer, patient advocate, health coach, and long-distance cyclist. Jewels is the moderator of Diabetic Connect’s weekly #DCDE Twitter chat, and she and her daughter both live healthfully with type 1 diabetes.

If you've had diabetes long enough, I'm certain you've been asked this question: "Are you a 'brittle diabetic'?"

According to the National Institutes of Health, brittle diabetes "is characterized by severe instability of blood glucose levels with frequent and unpredictable episodes of hypoglycemia and/or ketoacidosis that disrupt quality of life, often requiring frequent or prolonged hospitalizations."

Brittle diabetes is most often found in women in their 20s and 30s but can occur in either gender at any point in life.

Is it a common diagnosis?

According to Diabetes Health, there are approximately 3,700 to 8,700 people in the United States living with this diagnosis. Put into perspective, according to JDRF there are approximately three million Americans living with type 1 diabetes.

What causes this form of type 1 diabetes?

There are many identified causes of brittle type 1 diabetes, such as:

Hormonal imbalances


Disease neglect or non-compliance

Other medical conditions (such as celiac disease)

Gastric emptying delays (that can occur with gastroparesis)

Drug or alcohol use

Abnormal insulin absorption

Are there treatments for brittle diabetes?

Depending on the underlying issues, treatments may make brittle type 1 diabetes easier to manage once the culprit is identified. For example, if there is undiagnosed celiac disease, a patient may be struggling with inflammatory bowel, gastric dumping, and severe low blood sugars due to malabsorption issues. Once diagnosed and a celiac diet is in place, diabetes management should be greatly improved.

Do I have it?

If you think you may have brittle type 1 diabetes, see your healthcare provider to address your concerns. The NIH has also set up a link enabling questions from the public about this disease to be answered. If you are interested in asking them further questions, contact the NIH about brittle diabetes here.

To learn more about this topic:

"Brittle" Diabetes
Discussion: Living with "Brittle" Diabetes