Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin
The mechanism and response to treatment of severe life–threatening hypoglycaemia (plasma glucose 1.15±0.73 mM/I [±SD]) was studied in eight Thai patients with falciparum malaria. Plasma insulin concentrations were inappropriately high (range 1.0−21.8 mU/I), lactic acidosis was common (arterial blood...
Saved in:
Main Authors: | , , , , |
---|---|
Other Authors: | |
Format: | Article |
Published: |
2018
|
Subjects: | |
Online Access: | https://repository.li.mahidol.ac.th/handle/123456789/22794 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Institution: | Mahidol University |
id |
th-mahidol.22794 |
---|---|
record_format |
dspace |
spelling |
th-mahidol.227942018-08-10T16:00:19Z Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin R. E. Phillips C. Hatz D. A. Warrell R. E. Phillips S. Looareesuwan D. A. Warrell M. E. Molyneux University of Oxford Mahidol University Liverpool School of Tropical Medicine Medicine The mechanism and response to treatment of severe life–threatening hypoglycaemia (plasma glucose 1.15±0.73 mM/I [±SD]) was studied in eight Thai patients with falciparum malaria. Plasma insulin concentrations were inappropriately high (range 1.0−21.8 mU/I), lactic acidosis was common (arterial blood lactic acid concentration 1.44—17.8 mM/I), but the glucose counterregulatory response, indicated by plasma cortisol, growth hormone, catecholamines and glucagon concentrations, was intact Hyperinsulinaemia was successfully treated in five patients by a continuous intravenous infusion of the long–acting somatostatin analogue Sandostatin (SMS 201—995), 50 μg/h. In volunteer studies a single intramuscular injection of Sandostatin (100 μg) suppressed quinine–induced hyperinsulinaemia within 15 min; this effect was maintained for 6 h. These results suggest that Sandostatin may be a safe and effective way of correcting the hyperinsulinaemic hypoglycaemia complicating quinine treatment of falciparum malaria. This treatment could be particularly useful in fluid–overloaded patients with recurrent hypoglycaemia despite dextrose infusions. © 1993 Oxford University Press. 2018-08-10T09:00:19Z 2018-08-10T09:00:19Z 1993-01-01 Article QJM. Vol.86, No.4 (1993), 233-240 10.1093/oxfordjournals.qjmed.a068802 14602393 14602725 2-s2.0-0027295258 https://repository.li.mahidol.ac.th/handle/123456789/22794 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0027295258&origin=inward |
institution |
Mahidol University |
building |
Mahidol University Library |
continent |
Asia |
country |
Thailand Thailand |
content_provider |
Mahidol University Library |
collection |
Mahidol University Institutional Repository |
topic |
Medicine |
spellingShingle |
Medicine R. E. Phillips C. Hatz D. A. Warrell R. E. Phillips S. Looareesuwan D. A. Warrell M. E. Molyneux Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin |
description |
The mechanism and response to treatment of severe life–threatening hypoglycaemia (plasma glucose 1.15±0.73 mM/I [±SD]) was studied in eight Thai patients with falciparum malaria. Plasma insulin concentrations were inappropriately high (range 1.0−21.8 mU/I), lactic acidosis was common (arterial blood lactic acid concentration 1.44—17.8 mM/I), but the glucose counterregulatory response, indicated by plasma cortisol, growth hormone, catecholamines and glucagon concentrations, was intact Hyperinsulinaemia was successfully treated in five patients by a continuous intravenous infusion of the long–acting somatostatin analogue Sandostatin (SMS 201—995), 50 μg/h. In volunteer studies a single intramuscular injection of Sandostatin (100 μg) suppressed quinine–induced hyperinsulinaemia within 15 min; this effect was maintained for 6 h. These results suggest that Sandostatin may be a safe and effective way of correcting the hyperinsulinaemic hypoglycaemia complicating quinine treatment of falciparum malaria. This treatment could be particularly useful in fluid–overloaded patients with recurrent hypoglycaemia despite dextrose infusions. © 1993 Oxford University Press. |
author2 |
University of Oxford |
author_facet |
University of Oxford R. E. Phillips C. Hatz D. A. Warrell R. E. Phillips S. Looareesuwan D. A. Warrell M. E. Molyneux |
format |
Article |
author |
R. E. Phillips C. Hatz D. A. Warrell R. E. Phillips S. Looareesuwan D. A. Warrell M. E. Molyneux |
author_sort |
R. E. Phillips |
title |
Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin |
title_short |
Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin |
title_full |
Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin |
title_fullStr |
Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin |
title_full_unstemmed |
Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin |
title_sort |
hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: treatment with sandostatin |
publishDate |
2018 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/22794 |
_version_ |
1763490101546975232 |