Does “brittle” diabetes have something to do with an unstable insulin-glucagon production? Do people with brittle diabetes produce a lot of insulin at certain times and other times lots of glucagon?

Brittle diabetes refers to diabetes that is very difficult to control. It is an antiquated term that has no place in current management of diabetes.

MSB
Additional comments from Dr. Donough O’Brien:Brittle diabetes is a rather old fashioned term that used to be applied to cases of both type 2 and type 1 diabetes in which there were unpredictable and inexplicable fluctuations of blood or urine sugars and where ketoacidosis, often requiring hospitalisation, was frequent. It was not a specific diabetes variant and as the importance of diabetes education, the availability of home blood glucose monitoring, the understanding of factors other than diet in blood sugar levels and the important role of psychosocial factors in maintaining control became better understood the term fell into disuse. Nowadays poor control, as defined by a high HbA1c level, calls for a much more specific definition as to where the problem lies.

DOB