Glucose turnover in severe falciparum malaria

Abstract To investigate glucose metabolism in acute falciparum malaria, [3- 3 H]glucose turnover was measured in 18 normoglycemic adult Thais (eight males, 10 females; median age, 28 years) with severe infections. Eleven patients were studied before quinine treatment, 15 while receiving quinine, and 10 during convalescence. In paired studies conducted before and after initial intravenous quinine, plasma glucose level decreased from a median (95% confidence limits) of 5.5 (3.0 to 6.6) to 4.6 (2.5 to 6.1) mmol/L ( P ≤ .027 n = 8), and plasma insulin level increased 9.3 (−3.2 to 30.0) mU/L ( P = .02). Glucose turnover decreased during the 4-hour quinine infusion from 3.04 (2.12 to 4.23) to 1.89 (1.20 to 2.54) mg/kg · min −1 ( P −1 ; P = .008). Glucose turnover and clearance measured both after initaal quinine treatment and in convalescence were similar ( P = .234 and .344, respectively; n = 7). In the series as a whole, there was an inverse association between pretreatment turnover and the simultaneous plasma glucose level ( r s = −.76, P r s = −.88, P r s = .65, P