THE RELATIONSHIP BETWEEN GLUCOSE-PRODUCTION AND PLASMA-GLUCOSE CONCENTRATION IN CHILDREN WITH FALCIPARUM-MALARIA

The pathophysiology of hypoglycaemia in children with acute falciparum malaria, a frequent and serious complication, is unknown due to absen ce of data on glucose kinetics. We investigated the correlation betwee n basal glucose production and plasma glucose concentration in 20 chil dren (8 girls) with acute, uncomplicated falciparum malaria by infusio n of [6,6-H-2(2)]glucose. Median plasma glucose concentration was 4.5 (range 2.1-6.5) mmol/L and median glucose production 5.0 (range 4.1-8. 4) mg/kg/min. There was a positive correlation between basal glucose p roduction and plasma glucose concentration (r = 0.53, P = 0.016). Ther e was no correlation between the rate of glucose production and the pl asma concentrations of alanine, lactate, counter-regulatory hormones o r cytokines. It was concluded that in children with acute uncomplicate d falciparum malaria, endogenous glucose production is an important de terminant of plasma glucose concentration, contrary to previous findin gs in adults with malaria, in whom peripheral uptake seems to be more important than glucose production in determining plasma glucose concen tration.