Comparison of intravenous glucose tolerance tests and serum insulin levels in kwashiorkor and pellagra.

Abstract

Intravenous glucose tolerance tests and serum insulin responses were estimated on admission to hospital as well as after recovery in 16 kwashiorkor and 15 pellagra children. Only the kwashiorkor group showed impairment of glucose utilization on admission, and the glucose disappearance rate of the two groups differed significantly. After clinical recovery the glucose utilization of the kwashiorkor patients was much improved, and similar to that of the pellagra patients. These findings are different from those of others who reported persistent glucose intolerance after kwashiorkor. The glucose tolerance tests were normal in the pellagra group, both on admission and after recovery. The kwashiorkor group9s insulin response was less than that of the pellagra group on admission, and the values of the two groups differed significantly at 5, 15, and 30 minutes after glucose administration. After recovery, the insulin levels of the two groups were similar. The improvement in glucose utilization which took place on recovery of the kwashiorkor patients, as well as the low incidence of diabetes mellitus in the Bantu, cast doubt on the concept of permanent impairment of pancreatic endocrine function as a result of protein-calorie-malnutrition. It is speculated that glucose intolerance may be related to body potassium deficiency.