Highly fluctuating blood glucose in diabetes is a type of manifestation of “brittle diabetes” or “unstable diabetes” and is seen mainly in patients with type 1 diabetes and some advanced type 2 diabetes with near-islet failure, which often indicates complete islet failure. This often indicates complete islet failure. In this case, patients often need to rely entirely on exogenous insulin to control blood glucose, which is significantly different from physiological insulin secretion in terms of pharmacokinetic characteristics and regulation, plus the lack of effective auxiliary regulation of the patient’s body, so it is easy to experience high and low blood glucose and large fluctuations.
The clinical manifestation is that the patient is abnormally sensitive to insulin, and small changes in insulin dose can cause dramatic fluctuations in blood glucose. Sometimes even with a constant diet, exercise and insulin dose, the condition is extremely unstable, with repeated changes of hypoglycemia-hyperglycemia-ketoacidosis-coma. Fragile diabetes accounts for about 5% of type 1 diabetic patients, and patients are mostly accompanied by wasting, malnutrition symptoms. Treatment principles try to keep the amount of food, exercise insulin dosage constant injection method, minimize blood sugar fluctuations, try to avoid hypoglycemia and ketoacidosis.