Glucose kinetics during fasting in young children with severe and non-severe malaria in Suriname.
Fasting could be an important factor in the induction of hypoglycemia in children with malaria because fasting results in a decrease in endogenous glucose production. The influence of extended fasting on plasma glucose concentration, glucose production, and gluconeogenesis were measured using [6,6-(2)H(2)]glucose and (2)H(2)O in 12 Surinamese children with severe malaria and compared with 16 children with non-severe malaria during a 16-hour controlled fast. Glucose concentration and glucose production were comparable after 8 hours of fasting and decreased in both groups (P < 0.001) with an extension of the fast up to 16 hours. Glucose concentration decreased faster in the non-severe group than in the severe group (P = 0.029). The decrease in glucose production was not different between groups (P = 0.954). Thus, fasting predisposes for hypoglycemia in young children with Plasmodium falciparum malaria. Hypoglycemia caused by fasting develops later in young children with severe malaria than in children with non-severe malaria.
Department of Pediatrics, Diakonessen Hospital, Paramaribo, Suriname. zijlmans.dams@sr.net
Wilco
W
Zijlmans
Anne
A
van Kempen
Mariëtte
M
Ackermans
Jesse
J
de Metz
Piet
P
Kager
Hans
H
Sauerwein
D000409:Alanine / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002675:Child, Preschool; D005215:Fasting / Q000378:metabolism*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005943:Gluconeogenesis; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007700:Kinetics; D008288:Malaria / Q000378:metabolism*; D008297:Male
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D005947:Glucose; D000409:Alanine