Publication: Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin
Issued Date
1993-01-01
Resource Type
ISSN
14602393
14602725
14602725
Other identifier(s)
2-s2.0-0027295258
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Mahidol University
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SCOPUS
Bibliographic Citation
QJM. Vol.86, No.4 (1993), 233-240
Suggested Citation
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. QJM. Vol.86, No.4 (1993), 233-240. doi:10.1093/oxfordjournals.qjmed.a068802 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/22794
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Title
Hypoglycaemia and counterregulatory hormone responses in severe falciparum malaria: Treatment with Sandostatin
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Abstract
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.