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Discussion Starter · #1 ·
have you ever been 186, and 20 minutes later your were 36 and in trouble?:confused:
How about 340 and one hour 58.:eek:

There is little or not control for the brittle diabetic. It is a roller coaster you fight with all your life. Guess who wins?

Anyone on this roller coaster?
 

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Can type 2's be brittle? Supposedly my father was, but I've had a co-worker tell me my father's doctor was an idiot.
 

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I dont presume to know T1 a different disease from what I have. That said I have read that low carb results in lower insulin use results in less BG swings (law of smaller numbers ), have you, are you trying that approach.
 

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I may be showing my ignorance here but I thought the word "Brittle Diabetic" was an older term used for diabetics with poor control. With all the advances in testing, insulin pumps and CMG's I thought it is easier to figure out what is causing the swings in your bgs. Many D's will test every hour to figure out their basal insulin needs. Also the type of food you eat, when you exercise and the stress level of your life are definitely tied into bg control. Are you working with a good endo to figure out what is going on. Dr Bernsteins book is a very good place to start as is Thinking like a Pancreas by G. Schneider and Using Insulin by John Walsh
 

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PowerPumper said:
All diabetes is controllable. If you are not in control, then you haven't discovered your key variables and patterns.
Yea right. I was told the same thing every time I woke up in the ER. Not knowing more about the OP I would just like to say that I have been there. It wasn't until they diagnosed me with Addisons Disease that I found any kind of control. I would ask your endo to do an ACTH tolerance test. Good luck and let us know from time to time how you are doing.

Sent from my iPhone using Diabetes
 

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Yea right. I was told the same thing every time I woke up in the ER. Not knowing more about the OP I would just like to say that I have been there. It wasn't until they diagnosed me with Addisons Disease that I found any kind of control. I would ask your endo to do an ACTH tolerance test. Good luck and let us know from time to time how you are doing.

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I think all too often doctors don't keep testing everything until they find the source of the poor control. As you said many times there is something else going on with hormones. Without knowing more about the OP, it is hard to tell. But you should never give up.
 

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I may be showing my ignorance here but I thought the word "Brittle Diabetic" was an older term used for diabetics with poor control.
When my Daddy's doctor used the term 40 years ago, he meant that my Daddy's bg swung both very high and very low during a 6-hour glucose tolerance test. I assumed, at the time, that there was something significant or unique about that. But now I wonder: wouldn't most (all?) of us do the same thing?

The doctor's words became the basis for my Dad's (and thus the whole family's) eating patterns and times. Daddy was like a robot in that way! It is now noon. I will ingest a tuna sandwich, half a cup of pumpkin, 8 ounces of milk, and an apple. Variety does not compute. :p

D4Hope, I hope you figure this out. What you're going through sounds miserable.
 

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I will ingest a tuna sandwich, half a cup of pumpkin, 8 ounces of milk, and an apple. Variety does not compute. :p
Good lord,.. He had carbs and tuna, 1/2 cup of carbs, 8 OZ of carbs, and a round red pile of carbs.:eek:

Not to sure about the pumpkin
 

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Good lord,.. He had carbs and tuna, 1/2 cup of carbs, 8 OZ of carbs, and a round red pile of carbs.:eek:

Not to sure about the pumpkin
And it worked for him! He followed the old ADA exchange diet for 40 years and never had another high bg reading (not one that was caught, anyway) or any diabetic complications. He died last year at 83 from complications of Parkinsons. Go figure.
 

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Brittle diabetes was a term long ago done away with.......
I would ask to see if your pancreas is still throwing out insulin I think that's C-peptide? it's like 4 am in the morning and I'm trying to use my brain.
Also when were these numbers taken? That can make a difference to.
I'm "Insulin sensitive" and take itty amounts of insulin.
Another possibility is your being to aggressive with your highs and causing yourself to crash.
I've "Been there" but I'd never throw the term brittle out there......
 

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Discussion Starter · #15 · (Edited)
Interesttingly, Over the past 10 months I have developed "hang time". I call it that because I had never experienced it before.
Before if I tested and I was under 200 I had to find sugar, because I could be hypoglycemic within minutes. Now, I find I can be 118 and three hours later be 114. I can wake at 153, not eat and at 1pm be 212.
Things have changed greatly. I am having trouble trusting my hang time.
I think when I am comfortable enough to trust it, my A1c will come down.
Even with the pusatile I still have 340s and 47s, just a lot fewer of them.
 

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I don't know anything about your current lifestyle, knowledge, or control. I am merely basing this off what I have read here, maybe you already know all this or maybe you will be able to get something helpful from this.

An increase in the morning is normal (in the sense that it's a biological effect), however can be corrected. Dawn phenomenon is when after sleeping for a certain period of time, it's believed the liver deactivates insulin, causing a rise in bg in the morning.

Insulin absorption rates vary depending on location. The amount of insulin that reaches the blood stream varies on the location and the amount injected at the time. The more you inject, the greater the variation of how much actually makes it into the blood. There are a great many of other factors too, such as having a hot bath right after taking an injection. That can cause a rapid absorption and set you up for hypoglycemia.

Taking multiple corrections in a short period of time. The first correction can take a couple hours to have the proper effect. I've personally seen with myself a correction to start taking effect in approximately 30 minutes upwards to a couple hours.

High BG causes insulin resistance. Eating high amounts of carbohydrates can cause a spike in BG which can result in insulin resistance which makes any prediction difficult. Plus factoring in absorption rates and the amount of insulin that is actually used.

As already mentioned, have you tried a low carbohydrate diet? It can make prediction vastly easier, cause lower insulin dosages which means smaller margins of error, smaller mistakes, smaller corrections and results in smaller variance of readings.

Of course, your lifestyle, medications, and biological factors could be contributing too.
 

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Discussion Starter · #17 · (Edited)
Thank you.
You are very well versed in the facts.
I have had the same endocrinologists for 28 years, 15 in the practice. We have all been frustrated for 28 years.
I can follow all their directions to the letter, and still my sugar does what it wants to.
I eat low carb. I have some coke and a few crackers on hand for lows. The remainder of my foods are non-processed, fresh and raw.
I drink only water, always. No artificial sweeteners.

I believe I have found a treatment that helps. Over the years I have accumulated plenty of serious complications. Prevention is no longer a priority.
Slowing down, halting and reversing the lethal complications and a better quality of life is. This treatment has already halted and slightly reversed my kidney dysfunction, neuropathy, and boosted my energy level, greatly.
I still eat right and my pump keeps pumping, but twice a month I go to a clinic and sit for a 4 hour treatment of Pulsatile IV insulin Therapy.
I have done some reading on some other, "famous" and wealthy brittle diabetics.They are all dead now, but even with all their resourses available, not one I read about was able to get solid control for a solid length of time.
I have stopped beating myself up when I get a high. And with this treatment, I have not had a serious low in a little over a year. My quality of life is 100 times better than it was 2 years ago.
Now I am looking into C-peptide replacement therapy. I understand it has shown good progress in reversing kidney failure.
Keep, keeping up on the good information you have shared.
God Bless
 

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I would like to let you know that you aren't alone in having blood sugars that can go quickly from a high number to a low number. Recently I dropped 125 points in 20 minutes. It isn't always easy to manage these situations even with a pump. You seem to have good management skills - just keep up the good work and try not to be too discouraged :)
 

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I would HIGHLY recommend getting a CGMS. Since you already have a pump, it should not be too hard.
My BS has also fluctuated like yours and I too am a "brittle diabetic." The CGMS has been extremely helpful. It is not knowing the actual BS number that helps, but is how fast my BS is changing that is most important. For example, say I want to exercise. If my BS is 120, I should be O.K. Right? Not if my BS was just 220 a half hour ago. If I exercised, I would have a severe crash. But say my BS was 120 one hour ago, then it would be a great time to exercise!

Before I got the CGMS, I thought by checking my BS every hour I knew what was going on. NOT EVEN CLOSE! I think you would be surprised how well it works.
 

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Discussion Starter · #20 ·
There are many brittle diabetics. Many young endocrinologists that make a brittle think it is their fault, or the parents fault. As time goes by they all come to realize brittle is brittle, thats all.
Oh, actually I am pretty proud of myself. I have been t1 for over 30 years.
My eyes are find, I am fighting to keep my kidneys going, but, for now they are just fine. With this treatment I have been able to get off my pain med(neuropathy) and two blood pressure meds.
Thanks SMILES
 
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