| Abstract: |
This article contends that the 'diagnosis' of brittle diabetes is a myth, that there is really no such diagnosis and there is usually a logical explanation for variations in blood glucose readings. The author encourages readers to keep good records as the first step in demystifying seemingly outrageous blood glucose variations. A good set of records should include blood glucose values, insulin or oral medicine doses, the amount of carbohydrate eaten at meals and snacks (with notes about high fat or extra-large meals), and physical activities, including both formal exercise and daily activities such as shopping, yard work, and extended walking. Other topics covered include sources of variability, the different types of insulin (and their activity profiles), food intake, types of food, physical activity, hormones (related to stress, illness, menstruation, puberty), the role of additional SMBG during times of difficult blood glucose management, disease progression, and the impact of sleep, caffeine, alcohol, medications, and travel on blood glucose levels. |