The association between asymptomatic malaria and blood glucose among outpatients in a rural low-income setting

Background

Malaria and haemolysis have been linked to a preponderance of altered glycaemic indices. This study set out to estimate the association between asymptomatic malaria and the Fasting Plasma Glucose (FPG), glycated haemoglobin (HBA1c) and Oral Glucose Tolerance (OGT) tests.

Methods

A cross-sectional survey was conducted at a general hospital in eastern Uganda. Eligible participants were patients aged 30–75 years, seeking care at the outpatient department, of unknown diabetes status. Participants were tested for FPG, OGT and HBA1c tests. Multiple linear regression and ROC curve analysis were conducted for the three tests.

Results

A total of 504 participants were enrolled on the study, of whom 78.4% (395) were female. After adjusting for age, sex, and BMI, individuals with asymptomatic malaria had lower average HBA1c [-5 mmol/mol (95% CI, -7 -2) and OGT tests levels [-1.75 mmol/l (-2.6, -0.8)]. The optimal cut-off points for diabetes among individuals with asymptomatic malaria were lower for the HBA1c test [6.5% (47 mmol/mol) versus 6.6% (49 mmol/mol), respectively] but higher for the FPG test (6.6 mmol/l versus 6.2 mmol/l, respectively).

Conclusions

These findings may have implications for diabetes screening in malaria-endemic settings.