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From Piqua, Ohio, USA

My daughter was diagnosed with Type 1 in January 1999. Since then I have had a lot of well wishers and advice. One question that I have been asked, has me wondering is it just old wording or is there something to it. What is a "brittle diabetic"? What do people mean when they ask is "she a severe diabetic?" She has Type 1. Can there be a more serious case? Is this just an old figure of speech?

She is only 12 years old and has no complications. We are in control. She is insulin dependant, until a cure is found. We are keeping a positive attitude. I thank you in advance for your time and input.


The term 'brittle', as you suggest, has always been a euphemism for poor control; but with the added and incorrect inference that it is some special form of diabetes that is not amenable to greater effort. In recent years, as the importance of keeping blood sugars as near normal as possible and A1c levels within two percentage points of the upper level of normal or better has been emphasised, the term has persisted for the few that in whom these standards still seem to be out of reach. Fortunately the availability of new insulins like Lispro, of new dosage regimes, of increasingly sophisticated pumps and perhaps most importantly of the realization of the importance of psychosocial issues at home and at school as well as of exercise and dietary compliance have made these demanding new goals easier to achieve. The term 'severe' has the same connotation except where it refers to older people with significant complications.

It sounds as though your daughter is doing splendidly and with luck there will be some form of reliable external pancreas before she is through with college.


Original posting 9 Mar 1999
Posted to Daily Care


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