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Remember that the information presented here is not intended to replace the care of your own doctor. Before making any changes in the management of your own illness, you should consult your physician or other qualified medical professionals.
Question
My dad has just discovered he has a tumour on his pancreas, and it has to be removed which will leave him with brittle diabetes. What is the mortality rate of people suffering from this? What type of quality of life do they have?Answers
My best wishes for your father's speedy recovery. Brittle diabetes is not a distinct entity, and thus I do not believe there is more change in diabetes-related death rates from having one's pancreas removed vs. having long-standing type 1 diabetes from the usual autoimmune cause. When people refer to having "brittle diabetes" they are implying that there are many, many wide fluctuations in blood glucose from very, high to extremely low. Often those patients who claim they have "brittle" diabetes actually just have poorly controlled diabetes because they are not properly matching meal planning, physical activity, and insulin dosing. With proper education, typically with a recognized diabetes education program, and genuine attention to meal planning, I would not expect super-wide fluctuations.Now that is not to say that a person with diabetes never has glucose fluctuation, could never have a serious low glucose level or could never have serious high levels that progress to diabetic ketoacidosis. But recurrent "unexplained" highs and lows should not typically occur with attention to those issues relayed above.
So I would tend to have you shy away from any concept of "brittle" diabetes and focus on the important issues of diabetes education, meal planning, regular activity, and insulin dosing. The newer insulin regimens of dosing insulin in a "basal-bolus" manner, whereby a low level, background insulin (the "basal" insulin) is given in conjunction with extra insulin with doses based on food consumption (the "bolus" dose) can help minimize wide, frequent glucose fluctuations.
Prevalence and Incidence of Secondary and Other Types of Diabetes is a chapter in an endocrine textbook, at the National Insitutes of Health - National Institute of Diabetes, Digestive and Kidney Disorders website, and it is quite "technical." However, it is informative and may be able to answer some of your questions. [http://diabetes.niddk.nih.gov/dm/pubs/america/pdf/chapter5.pdf (PDF file)].
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