Glucose Metabolism In Quinine‐Treated Patients With Uncomplicated Falciparum Malaria

SUMMARY To investigate host and drug effects on glucose metabolism in acute falciparum malaria, 10 previously untreated, fasting Thai males with uncomplicated infections were given a 2-h intravenous glucose infusion (5 mg/kg ideal body weight min) with an infusion of quinine dihydrochloride (10 mg/kg body weight) during the second hour. Eight patients were restudied in convalescence. Fasting plasma glucose (mean ± SD) and insulin (geometric mean (— SD to + SD)) were higher during acute illness (5.5 ± 1.0 mmol/l and 6.2 (5.0–7.7) mU/l) than in convalescence (4.2 ± 0.25 mmol/l and 3.7 (2.1–6.7) mU/l; P 0.5). Basal plasma free fatty acid concentrations were increased in acute illness (0.68 ±.24 vs 0.21 ± 0.12 mmol/l, P < 0.001) but fell to low levels at 2 h in both studies. These data suggest tissue insulin resistance and augmented quinine-stimulated insulin secretion in acute falciparum malaria, factors which are likely to influence the clinical situation in which malaria-associated hypoglycaemia occurs.