Insulin Resistance is a major factor among patients
with critical illness due to various causes. Severe
falciparum malaria with MODS diagnosed as per the
criteria of MSS and admitted to the Medical ward of our
hospital were assessed for IR and β cell function by using
homeostasis model assessment.
75 consecutive patients of SFM admitted to the
Medical ward of our hospital were included in this study.
Malaria was diagnosed as per criteria of WHO and
organ dysfunction was diagnosed as per Malaria
Severity Score. Insulin Resistance and β cell function
was assessed by using homeostasis model assessment on
Day-1 and Day-7.
Out of 75 patients of severe falciparum malaria
with MODS 2, 3, 4, and 5 organ dysfunctions constituted
16 (21.3%), 34 (45.3%), 16 (21.3%), and 9 (12.0%)
patients, respectively.Hepatic failure was the most
common organ system failure (n=58; 77.3%), followed
by neurological (n=50;66.6%) ,renal (n=40;53.3%),
hematological (n=30; 40.0%), and, respiratory failure (
n=15; 20.0%). Hyperglycemia was present in 25 (33.3%)
cases where as normoglycemia was present in 50 (66.6%)
cases. The values of FBS, Tg, insulin, IR, and β cell
function decreased on Day-7 compared to Day-1 after
recovery from critically ill state. The patients who died
had a high insulin value, IR, but low β cell dysfunction
compared to the survivors.
This study showed that IR and β cell dysfunction
were associated with severe malaria with MODS with