Related Experiment Videos
Prevalence and characteristics of brittle diabetes in Britain
Insights
Brittle diabetes, characterized by severe glycaemic instability and hospitalizations, affects approximately 1 in 1000 diabetic patients. This condition predominantly impacts young females, often presenting with recurrent ketoacidosis, while older individuals may experience hypoglycaemia or mixed instability.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Public Health
Background:
- Brittle diabetes, defined by glycaemic instability and recurrent hospitalizations, presents a significant challenge in diabetes management.
- Understanding the prevalence and characteristics of brittle diabetes is crucial for targeted interventions.
Purpose of the Study:
- To investigate the prevalence and clinical characteristics of brittle diabetes in the UK.
- To identify demographic patterns and common manifestations of brittle diabetes.
Main Methods:
- A national questionnaire survey was distributed to physicians and paediatricians managing diabetic clinics across the UK.
- Data from 414 reported brittle diabetes patients were analyzed, with a 72% physician return rate.
Main Results:
- Brittle diabetes affects approximately 1.2 per 1000 diabetic patients (2.9 per 1000 insulin-treated), with an average of one brittle patient per clinic.
- The condition predominantly affects young females (mean age 26 years), with recurrent ketoacidosis being the most common form (59%).
- Older patients and those with recurrent hypoglycaemia or mixed instability showed different demographic profiles, and psychosocial factors were frequently cited as causes.
Conclusions:
- Brittle diabetes is a significant, though relatively uncommon, complication of diabetes, particularly affecting young females with recurrent ketoacidosis.
- Older individuals with brittle diabetes are more prone to hypoglycaemic or mixed glycaemic instability.
- Psychosocial issues are widely perceived as key underlying factors contributing to brittle diabetes.
Abstract:
We investigated the prevalence and characteristics of 'brittle diabetes', defined as insulin-dependent diabetes mellitus associated with glycaemic instability of any type, leading to life disruption with recurrent and/or prolonged hospitalizations. A questionnaire was sent to all physicians and paediatricians running diabetic clinics in the UK, from lists held at the British Diabetic Association. A total of 414 brittle patients were reported (72% questionnaire return). Most were young (mean age +/- SD was 26 +/- 15 years), though there was a small peak at ages 60-70 years. There was an excess of females (66%) and overall clinic prevalence was 1.2 per 1000 diabetic patients and 2.9 per 1000 insulin-treated diabetic patients. On average, there was 1.0 brittle patient per diabetic clinic. The most common form of brittleness was recurrent ketoacidosis (59%), with 17% having predominant hypoglycaemia, and 24% mixed instability. Female excess was highest and mean age lowest in the recurrent ketoacidosis group, whilst the reverse was true for those with recurrent hypoglycaemia. Causes of brittleness were offered by 58% of consultants, and most (93%) considered various psychosocial problems as likely underlying factors. We conclude that brittle diabetes is a small but significant problem, currently affecting about 1 per 1000 diabetic patients. Most, but by no means all, are young females--often with recurrent ketoacidosis. Older age groups are more likely to have recurrent hypoglycaemic or mixed types of brittleness. Perceived causes of brittleness are usually psychosocial.