ABOUT THE JOURNAL The Diabetes & Metabolism Journal is an official publication of the Korean Diabetes Association. Recurrent hypoglycaemic brittleness of psychological origin has a poor prognosis.Please read the complete instructions for authors before submitting your manuscript to the Diabetes & Metabolism Journal via or. Once the underlying cause is removed it tends to improve.
CONCLUSIONS-Brittle diabetes is often episodic and almost always related to stressful life circumstances. Brittle diabetes was in most cases related to a specific situation, usually unhappiness at home or school. Two died of uraemia within a year after ascertainment and two others in hypoglycaemic coma seven and 12 years later. Seven patients had pure hypoglycaemic brittleness, and five had also had eight or more admissions with ketoacidosis (mixed brittleness). One man died of a cerebral tumour but five of the surviving nine patients had not been admitted in the past two years, although diabetic control remained poor (median haemoglobin A1 concentration 14%). RESULTS-Patients with recurrent ketoacidosis had had a median (range) of 28 (8-67) episodes. MAIN OUTCOME MEASURES-Frequency of ketoacidosis and severe hypoglycaemia in the 12 years after ascertainment diabetic control and complications in 1988-90 retrospective attribution of the cause of brittleness. Two controls from our diabetic register were matched to each patient for age, sex, and duration of diabetes. SUBJECTS-25 brittle diabetic patients were identified in 1979-9 11 (five men) had three or more admissions with ketoacidosis between June 19 and 14 (eight men) had three or more attendances at the accident and emergency department with hypoglycaemia in 1978. DESIGN-12 year follow up of patients identified in 1977-9 as having brittle diabetes retrospective review of the case notes.
OBJECTIVE-To determine the course of brittle diabetes.
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