Sublingual sugar for hypoglycaemia in children with severe malaria: A pilot clinical study
Abstract Background Hypoglycaemia is a poor prognostic indicator in severe malaria. Intravenous infusions are rarely feasible in rural areas. The efficacy of sublingual sugar (SLS) was assessed in a pilot randomized controlled trial among hypoglycaemic children with severe malaria in Mali. Methods O...
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ftdoajarticles:oai:doaj.org/article:24f6bf80f1ef4583a0507b2641b262c2 2023-05-15T15:18:17+02:00 Sublingual sugar for hypoglycaemia in children with severe malaria: A pilot clinical study Giani Sergio Forster Mathieu Falquet Jacques Lambert Bernard Willcox Merlin L Dicko Moussa Graz Bertrand Diakite Chiaka Dembele Eugène M Diallo Drissa Barennes Hubert 2008-11-01T00:00:00Z https://doi.org/10.1186/1475-2875-7-242 https://doaj.org/article/24f6bf80f1ef4583a0507b2641b262c2 EN eng BMC http://www.malariajournal.com/content/7/1/242 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-7-242 1475-2875 https://doaj.org/article/24f6bf80f1ef4583a0507b2641b262c2 Malaria Journal, Vol 7, Iss 1, p 242 (2008) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2008 ftdoajarticles https://doi.org/10.1186/1475-2875-7-242 2022-12-31T00:39:08Z Abstract Background Hypoglycaemia is a poor prognostic indicator in severe malaria. Intravenous infusions are rarely feasible in rural areas. The efficacy of sublingual sugar (SLS) was assessed in a pilot randomized controlled trial among hypoglycaemic children with severe malaria in Mali. Methods Of 151 patients with presumed severe malaria, 23 children with blood glucose concentrations < 60 mg/dl (< 3.3 mmol/l) were assigned randomly to receive either intravenous 10% glucose (IVG; n = 9) or sublingual sugar (SLS; n = 14). In SLS, a teaspoon of sugar, moistened with a few drops of water, was gently placed under the tongue every 20 minutes. The child was put in the recovery position. Blood glucose concentration (BGC) was measured every 5–10 minutes for the first hour. All children were treated for malaria with intramuscular artemether. The primary outcome measure was treatment response, defined as reaching a BGC of >= 3.3 mmol/l (60 mg/dl) within 40 minutes after admission. Secondary outcome measures were early treatment response at 20 minutes, relapse (early and late), maximal BGC gain (CGmax), and treatment delay. Results There was no significant difference between the groups in the primary outcome measure. Treatment response occurred in 71% and 67% for SLS and IVG, respectively. Among the responders, relapses occurred in 30% on SLS at 40 minutes and in 17% on IVG at 20 minutes. There was one fatality in each group. Treatment failures in the SLS group were related to children with clenched teeth or swallowing the sugar, whereas in the IVG group, they were due to unavoidable delays in beginning an infusion (median time 17.5 min (range 3–40). Among SLS, the BGC increase was rapid among the nine patients who really kept the sugar sublingually. All but one increased their BGC by 10 minutes with a mean gain of 44 mg/dl (95%CI: 20.5–63.4). Conclusion Sublingual sugar appears to be a child-friendly, well-tolerated and effective promising method of raising blood glucose in severely ill children. More frequent ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 7 1 242 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Giani Sergio Forster Mathieu Falquet Jacques Lambert Bernard Willcox Merlin L Dicko Moussa Graz Bertrand Diakite Chiaka Dembele Eugène M Diallo Drissa Barennes Hubert Sublingual sugar for hypoglycaemia in children with severe malaria: A pilot clinical study |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Hypoglycaemia is a poor prognostic indicator in severe malaria. Intravenous infusions are rarely feasible in rural areas. The efficacy of sublingual sugar (SLS) was assessed in a pilot randomized controlled trial among hypoglycaemic children with severe malaria in Mali. Methods Of 151 patients with presumed severe malaria, 23 children with blood glucose concentrations < 60 mg/dl (< 3.3 mmol/l) were assigned randomly to receive either intravenous 10% glucose (IVG; n = 9) or sublingual sugar (SLS; n = 14). In SLS, a teaspoon of sugar, moistened with a few drops of water, was gently placed under the tongue every 20 minutes. The child was put in the recovery position. Blood glucose concentration (BGC) was measured every 5–10 minutes for the first hour. All children were treated for malaria with intramuscular artemether. The primary outcome measure was treatment response, defined as reaching a BGC of >= 3.3 mmol/l (60 mg/dl) within 40 minutes after admission. Secondary outcome measures were early treatment response at 20 minutes, relapse (early and late), maximal BGC gain (CGmax), and treatment delay. Results There was no significant difference between the groups in the primary outcome measure. Treatment response occurred in 71% and 67% for SLS and IVG, respectively. Among the responders, relapses occurred in 30% on SLS at 40 minutes and in 17% on IVG at 20 minutes. There was one fatality in each group. Treatment failures in the SLS group were related to children with clenched teeth or swallowing the sugar, whereas in the IVG group, they were due to unavoidable delays in beginning an infusion (median time 17.5 min (range 3–40). Among SLS, the BGC increase was rapid among the nine patients who really kept the sugar sublingually. All but one increased their BGC by 10 minutes with a mean gain of 44 mg/dl (95%CI: 20.5–63.4). Conclusion Sublingual sugar appears to be a child-friendly, well-tolerated and effective promising method of raising blood glucose in severely ill children. More frequent ... |
format |
Article in Journal/Newspaper |
author |
Giani Sergio Forster Mathieu Falquet Jacques Lambert Bernard Willcox Merlin L Dicko Moussa Graz Bertrand Diakite Chiaka Dembele Eugène M Diallo Drissa Barennes Hubert |
author_facet |
Giani Sergio Forster Mathieu Falquet Jacques Lambert Bernard Willcox Merlin L Dicko Moussa Graz Bertrand Diakite Chiaka Dembele Eugène M Diallo Drissa Barennes Hubert |
author_sort |
Giani Sergio |
title |
Sublingual sugar for hypoglycaemia in children with severe malaria: A pilot clinical study |
title_short |
Sublingual sugar for hypoglycaemia in children with severe malaria: A pilot clinical study |
title_full |
Sublingual sugar for hypoglycaemia in children with severe malaria: A pilot clinical study |
title_fullStr |
Sublingual sugar for hypoglycaemia in children with severe malaria: A pilot clinical study |
title_full_unstemmed |
Sublingual sugar for hypoglycaemia in children with severe malaria: A pilot clinical study |
title_sort |
sublingual sugar for hypoglycaemia in children with severe malaria: a pilot clinical study |
publisher |
BMC |
publishDate |
2008 |
url |
https://doi.org/10.1186/1475-2875-7-242 https://doaj.org/article/24f6bf80f1ef4583a0507b2641b262c2 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 7, Iss 1, p 242 (2008) |
op_relation |
http://www.malariajournal.com/content/7/1/242 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-7-242 1475-2875 https://doaj.org/article/24f6bf80f1ef4583a0507b2641b262c2 |
op_doi |
https://doi.org/10.1186/1475-2875-7-242 |
container_title |
Malaria Journal |
container_volume |
7 |
container_issue |
1 |
container_start_page |
242 |
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1766348485075927040 |