Over the last fifteen years attempts have been made to better understand what if anything can account for this rapid shifting in BG levels (what BDF calls the seesaw effect) for no apparent reason.
The evidence appears conclusive: there is always a secondary cause for brittle diabetes and that therapy should be directed at finding the cause(s) or etiology of the disease and then treating the underlying pathological factor(s). Results to date indicate that 50% of brittle diabetic patients respond favorably to treatment.
A major difficulty is that , at times, there is not a single cause but rather a combination of causes that result in the brittle condition.
Findings also indicate that people with psychosocial problems, those dealing with stress or depression, are at the highest risk for BD. It is for this reason that it is now recommended that a psychiatrist, psychologist or guidance counselor be included as part of the health care team when brittle diabetes is suspected.
There are three current theories as to the cause for brittleness.
1) Emotional stress leads to hormonal imbalance which in turn leads to the brittle condition. This psychological-hormonal link may influence the development of BD. Resolve the reason for the stress and/or depression, and the brittleness disappears.
2) Emotional stress leads to a shift in behavioral attitude resulting in individuals who neglect their self-care.This often results in their being justifiably labeled “non-compliant”.
Psychotherapy has proven effective in treating brittleness.
3) Organic or physiological causes, some known, others, yet to be discovered.
Once psychological problems have been excluded, treatment should focus on the underlying physiological or organic cause for brittleness whenever possible.
Known possible organic causes of Brittle Type 1 diabetes;
Gastroparesis compounded by marijuana and/or alcohol abuse
Absorption Disorders /Malabsorption Syndromes
Communication disorders requiring intervention by a speech language pathologist
Addison’s disease –hypoadrenalism
Cushing Disease –hyperadrenocorticism
Now that the 18 known causes have been explored, BDF will focus on any new developments in the research of Brittle Type 1 Diabetes including any additional causes that may come to light. N
