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[IP] Re: insulin-pumpers-digest V8 #55

On Wed, 31 Mar 2004 18:42:33 -0800, you wrote:

>>When my wife (who 
>>>also diabetic) mentioned that she (my wife) is brittle, the doctor replied,
>>>"We don't use the term 'brittle' anymore. We call that 'uncontrolled.'" My
>>>wife was seriously insulted and I wanted to smack the doctor. And she's a
>>>diabetes expert!
>>Gee, I only heard the term "brittle" a couple of years ago from my husband's 
>>new GP.  I still don't know what it means. Why "brittle"?  "Easily broken 
>>into a million pieces"?  A strange term indeed for "hypoglycemic 
>>unawareness", "soaring blood sugars for no reason at all" and "severe lows"
>>"Uncontrolled"?  I can't figure out why that's a replacement for "brittle".  
>>My husband had uncontrolled diabetes for 23 years i.e. he took one shot of 
>>Lente in the morning and one at night and ate pretty much what he wanted to 
>>the rest of the day.  Thank goodness he never ate sweets.  I'd say that was 
>>uncontrolled diabetes, wouldn't you?

As I understood it, the term brittle was in the past used to refer to folks who
often experienced, and were unable to control, frequent very wide swings in
blood sugar.  But I believe that term originated before the current era of
everyone with diabetes being used to relatively frequent blood sugar testing
with home equipment, as well as the more effective insulin therapies, including
MDI and the pump.  Some people, to be sure, have a harder time of controlling
 it, what with the possibility of combining type one diabetes itself with
 resistance, various side effects of neuropathy, and various lifestyles that
impact control.   But the net effect is the same.  If you're having wide swings
in blood sugar, your diabetes is not as well controlled as it should be.  Call
it brittle i you like or call it uncontrolled.   The word uncontrolled does not
imply anything other than that.  It is, after all, the same disease.   "Brittle
diabetes" isn't some special variant of the disease.  Just an indication that
for that particular patient, the therapies used apparently aren't working as
well as desired.   We all know that each patient is different, and some have an
easier time, either with therapies simply working more easily for them, or with
 the needed therapies simply being easier for some people to implement. Those of
us for whom control isn't so simple shouldn't bother with finding new, or old,
labels for the condition, but should simply explore our options and work out
what we can do to optimize our own situation as best we can.  I'd worry that
attaching labels like "brittle"  might tend to make someone fatalistically
accept an unacceptable level of control as being somehow inevitable for them,
 due to the fact that they are somehow different, or "brittle". I know I've had
to deal with that perception in my own case, and wasn't happy with realizing I
was doing that to myself.  It's hard enough dealing with the beast without
finding labels that tend to make one accept what should not be acceptable.

Peter Rowe
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