Ahrén B, Corrigan C B
Diabet Med. 1985 Jul;2(4):262-4.
Twenty-nine African patients regularly attending a diabetic clinic in northern Tanzania had a remarkable fluctuating clinical course. Initially the majority were stabilized on insulin, but after varying periods they no longer needed insulin and could be treated with oral hypoglycaemic agents. Acute infective illnesses occurring in these patients while they were on oral treatment did not necessitate insulin therapy. In a few patients even oral treatment was discontinued and dietary management was adequate. Ketoacidosis or other complications were rarely seen. However, insulin treatment had to be restarted in several patients without any precipitating factors such as stress, infection or pregnancy because diabetic symptoms became severe and the blood glucose levels were high. These episodes were temporary and the treatment regimens could again be changed later. Thus, a remarkable unpredictability regarding treatment regimens was seen. The patients were all over 25 years of age and there was a male preponderance. It is suggested that these patients cannot be classified as having either insulin-dependent or non-insulin-dependent diabetes.
29名定期前往坦桑尼亚北部一家糖尿病诊所就诊的非洲患者，其临床病程显著波动。起初，大多数患者通过胰岛素治疗病情得以稳定，但在不同时间段后，他们不再需要胰岛素，可用口服降糖药治疗。这些患者在接受口服治疗期间发生急性感染性疾病时，无需胰岛素治疗。少数患者甚至停用了口服治疗，饮食管理就足够了。很少见到酮症酸中毒或其他并发症。然而，一些患者在没有任何诸如压力、感染或妊娠等诱发因素的情况下，不得不重新开始胰岛素治疗，因为糖尿病症状变得严重且血糖水平很高。这些发作是暂时的，治疗方案随后可再次改变。因此，在治疗方案方面出现了显著的不可预测性。患者均超过25岁，男性居多。有人认为，这些患者不能归类为胰岛素依赖型或非胰岛素依赖型糖尿病。
