Amado Señaris J A
Med Clin (Barc). 1979 Nov 10;73(8):350-3.
Unstable diabetes is characterized by the appearance of irregular and unpredictable variations of the glycemia; because of this it is very difficult to achieve an acceptable metabolic control. There are different criteria (continuous monitorization, M value, MDDG, AMEG, etc.) for the evaluation of the degree of instability. Unstable diabetes may be transitory (generally related to exogenous factors or erroneous management) or permanent. The Somogyi effect must always be taken into account in unstable diabetes. The two most important pathogenic factors could be the absence of the pancreatic insulin reserve and the presence of small quantity of anti-insulin antibodies of high affinity. Other factors such as glucagon, growth hormone, catecholamines, etc. seem to play a secondary role. At the moment the treatment of unstable diabetes is not very satisfactory.
不稳定型糖尿病的特征是血糖出现不规则且不可预测的波动；因此，很难实现可接受的代谢控制。有不同的标准（连续监测、M值、平均每日血糖波动幅度、平均血糖波动幅度等）用于评估不稳定程度。不稳定型糖尿病可能是暂时的（通常与外部因素或错误管理有关）或永久性的。在不稳定型糖尿病中，索莫吉效应必须始终予以考虑。两个最重要的致病因素可能是胰腺胰岛素储备缺乏和存在少量高亲和力的抗胰岛素抗体。其他因素如胰高血糖素、生长激素、儿茶酚胺等似乎起次要作用。目前，不稳定型糖尿病的治疗效果不太令人满意。
