Abstract:
The study aimed at investigating the effects of adult uncomplicated malaria on insulin resistance. Fasting levels of blood glucose
(FBG), glycosylated hemoglobin (HbA1c), and serum insulin were measured in 100 diabetics and 100 age-matched controls before
and during Plasmodium falciparum malaria. Insulin resistance and beta cell function were computed by homeostatic models
assessment of insulin resistance (HOMAIR) and beta cell function (HOMAB) formulae, respectively. Body mass index (BMI) was
computed. At baseline, diabetics had significantly (𝑃 < 0.05) higher levels of BMI, FBG, HbA1c, and HOMAIR but lower level
of HOMAB than controls. Baseline insulin levels were comparable (𝑃 > 0.05) between the two study groups. During malaria,
diabetics maintained significantly (𝑃 < 0.05) higher levels of BMI, FBG, and HbA1c but lower levels of insulin and HOMAB than
controls. Malaria-induced HOMAIR levels were comparable (𝑃 > 0.05) between the two study groups but higher than baseline
levels. Apart from BMI and HOMAB, mean levels of all the remaining parameters increased in malaria-infected controls. In
malaria-infected diabetics, significant (𝑃 < 0.05) increase was only observed for insulin and HOMAIR but not the other measured
parameters. Uncomplicated malaria increased insulin resistance in diabetics and controls independent of BMI. This finding may
have implications for the evolution of T2DM in malaria-endemic regions.
