Brittle Diabetes: Clinical Characteristic Features and Outcome, Study of Fifty Patients Admitted to Ibn Sina-Teaching Hospital, Sirte-Libya

Abstract

Background/ Objective: There is few data on the clinical grounds of brittle diabetic patients in Libya. Such patients are enormously costly in terms of health care resources in Libya. In this study we tried to determine the underlying etiologies as well as precipitating factors in brittle diabetic patients who were admitted to medical department in Ibn Sina Hospital, Sirte-Libya.

Material and Methods: A retrospective study of all brittle diabetic patients admitted to the medical department in the period of March 2005 to February 2010. Patients age, gender, occupation, marital status, body mass index, hemoglobin A1c (glycosylated hemoglobin) concentrations, sub types of brittle diabetics and presence of diabetic complications as well as underlying causes were recorded.

Results: A total of 7184 patients were admitted, 50 (0.69%), out of them were defined as brittle diabetics. The mean age was 28.58±12.16 years with male to female ratio of (1.1:5.1). Admission with recurrent ketoacidosis was the commonest subtypes of brittleness (62%) followed by recurrent hypoglycaemia (22%) lastly mixed brittleness16%. Depression was the common underling problem among patients with recurrent ketoacidosis (52%), mental retardation (28%), severe personality disorder (7%), stress reaction (7%), dementia (3%) and congenital anomaly of urinary tract (3%). Sheehan's syndrome was the most underling disease in patients with recurrent hypoglycaemia (28%), chronic renal failure (27%), Addison’s disease (18%), factitious hypoglycaemia (9%) and Shmidts (48%). According to occupational, 48% were students, housewife (30%), Teachers (6%), female office worker (6%), Nurse (4%) and jobless (4%).