Adatsi, R., 2Pappoe, F., 3Bockarie, A. S., 4Derkyi-Kwarteng, L., 5Nsiah, P., 1Weyori, E. W.,
2Dankwa, K., 2Aniakwaa-Bonsu, E., 6Setorglo, J., and *6Acquah, S
1Public Health Reference Laboratory, Tamale Teaching Hospital, Tamale, Ghana
2Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
3Department of Internal Medicine and Therapeutics, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
4Department of Pathology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
5Department of Chemical Pathology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
6Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Ghana
*Correspondence to: firstname.lastname@example.org
Background: Scientific information on the impact of malaria on the risk of developing type 2 diabetes mellitus (T2DM) after recovery from the coronavirus disease 2019 (COVID-19) is limited in the Ghanaian context. The purpose of this study was to examine the association between selected risk markers of T2DM in falciparum malaria patients post-COVID-19 or not at a tertiary hospital in Ghana.
Methodology: This was a descriptive cross-sectional comparative study of 38-recovered COVID-19 adult participants with malaria and 40 unexposed COVID-19 adults with malaria at the Tamale Teaching Hospital, Ghana. Demographic, anthropometric and levels of glucose, insulin, C-reactive protein and lipid profiles were measured in the two groups of participants under fasting conditions. Parasitaemia was assessed micro- scopically but insulin resistance and beta-cell function were assessed by the homeostatic model.
Results: The COVID-19 exposed participants were older (p=0.035) with lower parasitaemia (p=0.025) but higher mean levels of insulin, insulin resistance, and beta-cell function compared with their unexposed counterparts (p<0.05). Parasitaemia correlated positively with a number of the measured indices of diabetogenic risk markers in the COVID-19 exposed group only, and predicted (Adjusted R2=0.751; p=0.031) by beta-cell function, C-reactive protein and triglycerides with the model explaining about 75% of the observed variation. Parasitaemia could only be predicted (Adjusted R2=0.245; p=0.002) by C-reactive protein with the model explaining just about a quarter of the observed variation in the COVID-19 unexposed group. Insulin resistance and sub-optimal beta-cell function were detected in both groups of participants.
Conclusion: Falciparum malaria is associated with risk markers for development of T2DM irrespective of COVID-19 exposure. Insulin resistance, inflammation and sub-optimal beta-cell secretory function may drive the risk. The observed diabetogenic risk is higher in the recovered COVID-19 participants.
Keywords: insulin resistance, falciparum malaria, type 2 diabetes mellitus, inflammation, COVID-19
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