From Wakefield, Rhode Island, USA:
I have two questions. My 22 year old daughter was diagnosed with Type 1 diabetes 11 years ago. What is a "brittle diabetic?" Is it true that once you're on the insulin pump, you can never go off?
You can come off a pump at any time; but very few people want to because it nearly always makes it possible to be in very good control besides which it affords great flexibility in the insulin regimen.
The term 'brittle diabetic' has for a long time been used as a euphemism for poor control and carried with it the implication that it was in fact a special form of diabetes and that the control problems were not amenable to more meticulous care. Nowadays the emphasis in a diabetic team would be starting more rigorous testing, on a more careful dietary interpretation, on new insulins like Lispro and more intensive insulin regimens, on exploring psychosocial causes of poor control and finally on considering the use of a pump.
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