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The relationship between glucose production and plasma glucose concentration in children with falciparum malaria
E Dekker1, J A Romijn, C Waruiru
1Department of Endocrinology and Metabolism, University of Amsterdam, The Netherlands.
Insights
In children with malaria, glucose production is key to maintaining blood sugar levels. This study reveals endogenous glucose production significantly impacts plasma glucose concentration in pediatric malaria patients.
Area of Science:
- Pediatric Infectious Diseases
- Metabolic Medicine
- Malaria Pathophysiology
Background:
- Hypoglycemia is a frequent and serious complication in children with acute falciparum malaria.
- The exact pathophysiology of hypoglycemia in this population remains unclear due to limited data on glucose kinetics.
Purpose of the Study:
- To investigate the correlation between basal glucose production and plasma glucose concentration in children with acute, uncomplicated falciparum malaria.
Main Methods:
- Utilized [6,6-2H2]glucose infusion in 20 children with acute falciparum malaria.
- Measured plasma glucose concentration and basal glucose production rates.
- Analyzed correlations with alanine, lactate, counter-regulatory hormones, and cytokines.
Main Results:
- A positive correlation was observed between basal glucose production and plasma glucose concentration (r = 0.53, P = 0.016).
- Median plasma glucose was 4.5 mmol/L and median glucose production was 5.0 mg/kg/min.
- No correlation found between glucose production and levels of alanine, lactate, hormones, or cytokines.
Conclusions:
- Endogenous glucose production is a critical determinant of plasma glucose concentration in children with acute uncomplicated falciparum malaria.
- This finding contrasts with adult malaria studies where peripheral glucose uptake appears more significant.
Abstract:
The pathophysiology of hypoglycaemia in children with acute falciparum malaria, a frequent and serious complication, is unknown due to absence of data on glucose kinetics. We investigated the correlation between basal glucose production and plasma glucose concentration in 20 children (8 girls) with acute, uncomplicated falciparum malaria by infusion of [6,6-2H2]glucose. Median plasma glucose concentration was 4.5 (range 2.1-6.5) mmol/L and the median glucose production 5.0 (range 4.1-8.4) mg/kg/min. There was a positive correlation between basal glucose production and plasma glucose concentration (r = 0.53, P = 0.016). There was no correlation between the rate of glucose production and the plasma concentrations of alanine, lactate, counter-regulatory hormones or cytokines. It was concluded that, in children with acute uncomplicated falciparum malaria, endogenous glucose production is an important determinant of plasma glucose concentration, contrary to previous findings in adults with malaria, in whom peripheral uptake seems to be more important than glucose production in determining plasma glucose concentration.