Prise en charge du patient porteur d'un diabète de type 1 instable

Brittle type 1 diabetes (T1D) represents a rare form of T1D. The prognosis of brittle diabetes is severe in term of morbidity, mortality, and impact on quality of life. It requires intensive therapeutic management. The clinical evaluation of brittle diabetes is possible through simple diagnosis tests. Etiologic diagnosis of brittle diabetes is fundamental and will guide the therapeutic approach of brittle T1D. Management of brittle diabetes requires a pluridisciplinary management involving diabetologist, nurse, dietetician, and psychologist. It requires sometimes expensive therapeutic strategies such as RT-CGM, or pancreas or islet transplantation. Despite their costs, such strategies may be useful to restore better glucose stability.