Brittle type 1 diabetes mellitus

Federico Bertuzzi, Roberto Verzaro, Vincenzo Provenzano, Camillo Ricordi

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

A small group of patients affected by type 1 diabetes mellitus is characterized by a severe instability of glycemic values with frequent and unpredictable hypoglycemic and/or ketoacidosis episodes which cannot be explained by errors of patients or diabetologists. The quality of life of these patients is dramatically compromised in particular because of the frequency of acute events, hospital recoveries and precocious appearance of chronic complications. This clinical condition has been defined as "brittle diabetes". A precise quantification of these patients is difficult because diagnostic criteria are still not well defined and it is often difficult to verify errors of patients in terms of inappropriate conduct with the pathology. Even more than the other kinds of diabetes, therapy is based on education, glycemic control, intensive therapy and strict interaction between physicians and patients. The introduction of insulin analogous, with either ultra-fast and ultra-slow action and the use of subcutaneous insulin pumps have significantly increased the possibility of treating the most of these cases. However, there is a minority of patients resistant to the therapy. In similar cases, pancreas or islet transplantation represents an effective therapeutic option entailing good expected outcomes. The main limiting factor of beta cell function replacement by transplantation is so far represented by the potentially severe side effects of the immunosuppression therapy necessary to avoid graft rejection and recurrence of autoimmunity.

Original languageEnglish
Pages (from-to)1739-1744
Number of pages6
JournalCurrent Medicinal Chemistry
Volume14
Issue number16
DOIs
StatePublished - Jul 1 2007

Fingerprint

Medical problems
Type 1 Diabetes Mellitus
Insulin
Pathology
Hypoglycemic Agents
Grafts
Education
Pumps
Recovery
Therapeutics
Pancreas Transplantation
Islets of Langerhans Transplantation
Ketosis
Graft Rejection
Autoimmunity
Immunosuppression
Transplantation
Quality of Life
Physicians
Recurrence

Keywords

  • Brittle diabetes mellitus
  • Continuous subcutaneous insulin infusion
  • Immunosuppression therapy
  • Insulin analogues
  • Islet transplantation
  • Pancreas transplantation

ASJC Scopus subject areas

  • Organic Chemistry
  • Biochemistry, Genetics and Molecular Biology(all)
  • Biochemistry
  • Pharmacology

Cite this

Brittle type 1 diabetes mellitus. / Bertuzzi, Federico; Verzaro, Roberto; Provenzano, Vincenzo; Ricordi, Camillo.

In: Current Medicinal Chemistry, Vol. 14, No. 16, 01.07.2007, p. 1739-1744.

Research output: Contribution to journalArticle

Bertuzzi, F, Verzaro, R, Provenzano, V & Ricordi, C 2007, 'Brittle type 1 diabetes mellitus', Current Medicinal Chemistry, vol. 14, no. 16, pp. 1739-1744. https://doi.org/10.2174/092986707781058922
Bertuzzi, Federico ; Verzaro, Roberto ; Provenzano, Vincenzo ; Ricordi, Camillo. / Brittle type 1 diabetes mellitus. In: Current Medicinal Chemistry. 2007 ; Vol. 14, No. 16. pp. 1739-1744.
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