title: Type of infectious disease affects glucose metabolism and liver glycogen content in Surinamese children: malaria vs. pneumonia.
abstract: OBJECTIVE
  Fasting is an important risk factor for hypoglycemia in children with malaria or pneumonia. Young children are more at risk because of impaired endogenous glucose production presumably due to smaller liver glycogen stores. The aim of this study was to measure the effect of a bolus of glucagon on glucose kinetics, as an indicator of glycogen content, in fasted children with malaria and pneumonia.
  
  
  METHODS
  After a 16-h controlled fast, plasma glucose concentration and endogenous glucose production were measured using [6,6-2H2]glucose in six children with severe malaria and 12 children with severe pneumonia who were 1-5 years of age before and after a bolus glucagon.
  
  
  RESULTS
  Basal glucose concentration and endogenous glucose production were higher in children with malaria, p=0.034 and p=0.010, respectively. After glucagon, the increase in the plasma glucose concentration was higher in children with malaria (52±26% vs. 31±23%, p=0.029). Also, the increase in glucose production was higher in children with malaria (106±42% vs. 70±52%, p=0.023). There were no differences in the fasting duration or duration of illness.
  
  
  CONCLUSIONS
  This is the first study to show infectious disease-related differences in the adaptation of glucose metabolism to fasting in young children. It was found that basal glucose concentration and endogenous glucose production were higher in children with malaria. The increase in plasma glucose concentration and endogenous glucose production in response to glucagon was higher in children with malaria, indicating smaller glycogen stores in children with pneumonia.
authors: Department of Pediatrics, Diakonessen Hospital, Paramaribo, Suriname. cwrzijlmans@gmail.com
authors: Wilco
authors: W
authors: Zijlmans
authors: Jeetendra
authors: J
authors: Jitan
authors: Mariëtte T
authors: MT
authors: Ackermans
authors: Mireille J
authors: MJ
authors: Serlie
authors: Anne A M W
authors: AA
authors: van Kempen
authors: Hans P
authors: HP
authors: Sauerwein
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D002675:Child, Preschool; D005215:Fasting / Q000502:physiology; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D005934:Glucagon / Q000008:administration & dosage; D006003:Glycogen / Q000378:metabolism*; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000378:metabolism*; D007223:Infant; D007328:Insulin / Q000097:blood; D008099:Liver / Q000378:metabolism*; D008288:Malaria / Q000453:epidemiology / Q000378:metabolism*; D008297:Male; D008954:Models, Biological; D010865:Pilot Projects; D011014:Pneumonia / Q000453:epidemiology / Q000378:metabolism*; D012307:Risk Factors; D013532:Suriname
chemical_list: D001786:Blood Glucose; D005765:Gastrointestinal Agents; D007328:Insulin; D006003:Glycogen; D005934:Glucagon