Hypoglycaemic Response to Exogenous Insulin in Children with Protein Energy Malnutrition.

Abstract

Summary:  Response to an intravenous bolus of insulin was investigated in 38 children with protein energy malnutrition (15 with kwashiorkor, 12 marasmic kwashiorkor and II with marasmus) and a group of 14 well-nourished children (controls), by moni toring the subsequent changes in the blood sugar levels. The mean fasting blood sugar (FBS) in children with kwashiorkor was 3,15 mmol/l and in marasmic-kwashiorkor, 3.17mmol/1. The marasmic children and the controls had mean FBS of 3.86mmol/l and 4.28mmol/l respectively; one child among the marasmic group had a FBS below 2.22mmol/L. Children with kwashiorkor had a sluggish but prolonged hypog lycaemic response to insulin which was not seen in the controls or in other sub groups. It is speculated that the slow recovery of blood sugar from hypoglycaemic to normoglycaemic levels in patients with kwashiorkor might be due to a defect in the homeostatic glycogenolytic pathway.