Brittle Diabetes (Recurrent Diabetic Ketoacidosis)

DC 7913Endocrine38 CFR 4.119, DC 7913

Brittle diabetes is a severe form of diabetes where blood sugar swings wildly between very high and very low despite careful management. The VA rates this based on how many hospitalizations and activity restrictions you have.

How the VA rates this condition

The VA rates this condition based on the type and intensity of treatment you require. Higher ratings correspond to more aggressive treatment regimens, such as daily medication, insulin dependence, or the need for ongoing medical management.

Diagnostic code

DC 7913

Rating range

40% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.119, DC 7913. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

Your brittle diabetes requires more than one daily injection of insulin, a restricted diet, regulation of activities, and you have episodes of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations per year or weekly visits to a diabetic care provider, plus progressive loss of weight and strength.

What the VA looks for

Multiple daily insulin injections documented
Three or more hospitalizations per year for DKA or hypoglycemia
Weekly diabetic care provider visits
Progressive weight loss documented
Progressive loss of strength documented
Severe complications (nephropathy, retinopathy, neuropathy)

Common Pitfalls

⚠Not documenting "regulation of activities" — this must be a physician-prescribed restriction, not just your own choice to limit activities. Ask your doctor to write that you must avoid strenuous activity due to diabetes.
⚠Not keeping records of all emergency room visits and hospitalizations for DKA or severe hypoglycemia — the number of hospitalizations per year directly determines your rating level.
⚠Not filing for secondary conditions separately — diabetic neuropathy, retinopathy, nephropathy, and erectile dysfunction each qualify for their own rating in addition to the diabetes rating.
⚠Not documenting progressive weight loss and strength loss, which are required evidence for the 100% rating level.

Related DBQ Forms

DBQ Diabetes Mellitus

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

How the VA rates this condition

Diagnostic code

DC 7913

Rating range

40% – 100%

Rating levels

Rating Levels

What the VA looks for

Multiple daily insulin injections documented
Three or more hospitalizations per year for DKA or hypoglycemia
Weekly diabetic care provider visits
Progressive weight loss documented
Progressive loss of strength documented
Severe complications (nephropathy, retinopathy, neuropathy)

Common Pitfalls

⚠Not documenting "regulation of activities" — this must be a physician-prescribed restriction, not just your own choice to limit activities. Ask your doctor to write that you must avoid strenuous activity due to diabetes.

⚠Not keeping records of all emergency room visits and hospitalizations for DKA or severe hypoglycemia — the number of hospitalizations per year directly determines your rating level.

⚠Not filing for secondary conditions separately — diabetic neuropathy, retinopathy, nephropathy, and erectile dysfunction each qualify for their own rating in addition to the diabetes rating.

⚠Not documenting progressive weight loss and strength loss, which are required evidence for the 100% rating level.