Patients with brittle type of diabetes readily develop hypoglycemia, which can lead to unconsciousness, or hyperglycemia, which can lead to ketoacidosis, even if they maintain a reasonable diet and receive insulin therapy.1 As a result, it is difficult to control the diabetic state of such patients. In addition, if esophageal stenosis or hyperthyroidism accompanies brittle diabetes, blood glucose levels may fluctuate even more than with brittle diabetes alone.
Yoshioka K, Ando T, Inoue K, Hiraoka N, Kasamatsu Y, Yoshida T, Kondo M. Esophageal Stenosis and Graves Disease in Brittle Type 1 Diabetes Mellitus. Arch Intern Med. 1998;158(12):1378-1379. doi: