Kalra Sanjay, Khandelwal Deepak, Singla Rajiv, Aggarwal Sameer, Dutta Deep
Department of Endocrinology, BRIDE, Karnal, India.
Department of Endocrinology, Maharaja Agrasen Hospital, New Delhi, India.
J Pak Med Assoc. 2017 May;67(5):810-813.
Both malaria and diabetes are more common in the developing world, and are major public health challenges. A direct relationship between these 2 conditions has not been evaluated. This review article assessed the literature guaging the relationship between these two conditions, and suggests a pragmatic approach to management. References for this review were identified through searches of PubMed, Medline, and Embase for articles published to October 2016 using the terms "diabetes" [MeSH Terms] AND "malaria" [All Fields]. The reference lists of the articles thus identified were also searched. The search was not restricted to English-language literature. Malaria has been documented to be more common in diabetes, in several studies from Africa. Malarial infection during pregnancy is an important cause of low birth weight and anaemia, and may contribute to the intra-uterine hypothesis explanation for the diabetes epidemic. Prevention and timely/effective management of malaria during pregnancy may therefore be viewed as a primordial preventive strategy against diabetes. Patients with diabetes have atypical malaria presentations. Glucose-6-phosphate dehydrogenase deficiency, which is associated with primaquine failure for radical cure is also associated with dysglycaemia. Type 2 Diabetic mice infected with malaria are more efficient at infecting mosquitoes. A similar synergy in humans warrants evaluation, which would then make "diabetic malaria" a public health problem. Metformin has well known anti-malarial properties. There is significant literature available highlighting the link between diabetes and malaria, an area warranting active further research. Metformin as a prophylactic agent for malaria prevention warrants evaluation.
疟疾和糖尿病在发展中世界都更为常见,并且都是重大的公共卫生挑战。这两种疾病之间的直接关系尚未得到评估。这篇综述文章评估了衡量这两种疾病之间关系的文献,并提出了一种务实的管理方法。通过在PubMed、Medline和Embase中检索截至2016年10月发表的文章来确定本综述的参考文献,检索词为“糖尿病”[医学主题词]和“疟疾”[所有字段]。还对如此确定的文章的参考文献列表进行了检索。检索不限于英文文献。在非洲的几项研究中,已有文献记载疟疾在糖尿病患者中更为常见。孕期疟疾感染是低出生体重和贫血的重要原因,可能有助于为糖尿病流行提供宫内假说解释。因此,孕期疟疾的预防和及时/有效管理可被视为预防糖尿病的一项初级预防策略。糖尿病患者有非典型的疟疾表现。葡萄糖-6-磷酸脱氢酶缺乏症与伯氨喹根治失败有关,也与血糖异常有关。感染疟疾的2型糖尿病小鼠在感染蚊子方面更有效。人类中类似的协同作用值得评估,这将使“糖尿病性疟疾”成为一个公共卫生问题。二甲双胍具有众所周知的抗疟特性。有大量文献强调了糖尿病与疟疾之间的联系,这是一个值得积极进一步研究的领域。二甲双胍作为预防疟疾的药物值得评估。