Testing blood glucose may be useful in the management of dengue

Recently dengue viral fever is observed each year in Bangladesh. Overall skills for diagnosis and management have improved owing to national awareness for the disease. We have observed and investigated the frequency of glucose intolerance in the early phase of dengue fever. A two-sampled challenge test by 75 gm oral glucose (OGTT) was done in 133 patients [age (mean+/-SD):33+/-13 years, sex (male/female): 97/36] suffering from dengue fever during their illness. Diagnosis of dengue was based on serologic test for anti-dengue antibodies after the first week. Other investigations were done as part of the management. Among 133 studied dengue patients, 100 were found to have glucose intolerance by OGTT (75.2%). In regards to intensity of intolerance, 21.1%(28/133) had diabetes while 54.1%(72/133) had impaired glucose tolerance (IGT). Among the patients who agreed for a second OGTT (n=40) during discharge, 11(28%) had normal OGTT at both events, 22(55%) revert to normal on second OGTT while 7(17.5%) persisted abnormal glucose intolerance. On regression analysis, glucose intolerance was independently related to increased age (p=0.001) and higher titre of IgG antibody (p=0.006). The study demonstrated that glucose intolerance is frequently associated with dengue fever in its early course. These findings may help for the early diagnosis of dengue fever; and warrants for avoidance of dextrose infusions as fluid replacement in dengue fever. Moreover, patients suffering from dengue fever should be cautioned for development of diabetes in future.