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CHAPTER ONE

INTRODUCTION

1.1   Introduction

Type 2 diabetes mellitus is a long term metabolic disorder that is characterized by high blood glucose, insulin resistance and relative lack of insulin (Pasquel and Umpierrez, 2014). The insulin resistance is the inability of cells to respond adequately to normal levels of insulin and this occurs primarily within the muscles,  liver and fat tissue. The proportion of insulin resistance versus beta cell dysfunction differs among individuals with some having primarily insulin resistance and only a minor defect in insulin secretion and others with slight insulin and primarily a lack of insulin secretion. (Maruthur  et al.,  2016). There are usually symptoms associated with type 2 diabetes mellitus which include: increased thirst, frequent urination, weight loss, increased hunger, feeling tired and having wounds that dont heal (Zaccardi et al., 2016).

Malaria is a mosquito borne infectious disease that affects humans and other animals. It is caused by parasitic protozoans belonging to the plasmodium type. The disease is commonly transmitted by an infected female anopheles mosquito.

The species of plasmodium that cause malaria are: plasmodium vivax, plasmodium falciparum, plasmodium ovale, plasmodium malaria and plasmodium knowleski. In all these, the plasmodium falciparum is the most common. (Cowman et al.,2012). The mosquito causes an infection by a bite. First, sporozoites enter the blood stream and migrate to the liver. They infect the liver cells where they develop into ring forms trophozoites and schizonts that in turn produce further merozoites. Sexual forms are also produced within, if taken up by a mosquito will infect the insect and continue the life cycle, (Vaughan et al., 2008).

The disease is widespread in the tropical and sub-tropical regions that exist in a broad band around the equator. In 2015, there were 214 million cases of malaria worldwide resulting in an estimated 438,000 deaths, 90% of which occurred in Africa (Owusu et al., 2010).

The liver is the largest internal organ in the body and functions in numerous ways  like in carbohydrate, fat and protein metabolism, blood detoxification and purification, excretion of waste products, storage of vitamins. It is also needed in the synthesis of liver enzymes like alanine transaminase, aspartate transaminase and alkaline phosphate. Whenever there is liver damage, it will lead to the leakage of enzymes from the hepatic cells causing numerous diseases (Nwosu, 2009).

 

  • JUSTIFICATION

Diabetes mellitus and malaria have continually been shown to be the major killers common in major developing countries, in spite of phenomenal progress in medical sciences. The present study is therefore aimed at assessment of liver function in diabetic patients with malaria infection hence finding the possible contribution of malaria infection of some organs to the pathophysiology of diabetes mellitus.

  • AIM

To evaluate the levels of liver function enzymes in Type 2 Diabetics with Malaria parasite infection

  • SPECIFIC OBJECTIVES
  1. To determine Serum levels of ALP in type 2 diabetics with malaria.
  2. To determine Serum levels of ALT in type 2 diabetics with malaria.
  3. To determine Serum levels of AST in type 2 diabetics with malaria.

 

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