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Related Concept Videos

Diabetic Ketoacidosis l: Introduction01:25

Diabetic Ketoacidosis l: Introduction

DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
Diabetic Ketoacidosis ll: Pathophysiology01:22

Diabetic Ketoacidosis ll: Pathophysiology

Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
Loss of Carboxy Group as CO2: Decarboxylation of Malonic Acid Derivatives01:35

Loss of Carboxy Group as CO2: Decarboxylation of Malonic Acid Derivatives

Just like β-keto acids—which upon thermal decarboxylation form ketones—β-dicarboxylic acids undergo decarboxylation to generate monocarboxylic acids with the liberation of carbon dioxide.
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
Oral Hypoglycemic Agents: &#945;-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are typically...
Diabetes Mellitus: Introduction01:26

Diabetes Mellitus: Introduction

Diabetes mellitus consists of chronic metabolic disorders characterized by persistent hyperglycemia. This elevated blood glucose results from defects in insulin secretion, impaired insulin action, or both. Insulin, produced by pancreatic β-cells, is essential for maintaining glucose homeostasis by facilitating cellular glucose uptake for energy or storage. Disruptions in insulin production or function lead to glucose accumulation in the bloodstream, causing the clinical features and long-term...

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Related Experiment Videos

Metformin-associated lactic acidosis (MALA): case report.

P J Hofkens1, S De Winter, P Vanbrabant

  • 1Department of General Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium. pieterxjan.hofkens@uzleuven.be

Acta Clinica Belgica
|December 8, 2011
PubMed
Summary

Metformin is a common diabetes treatment. Rarely, it can cause lactic acidosis, a serious condition requiring careful patient selection and monitoring.

Related Experiment Videos

Area of Science:

  • Endocrinology
  • Pharmacology
  • Nephrology

Background:

  • Metformin is a widely prescribed oral antihyperglycemic agent and the first-line treatment for type 2 diabetes mellitus.
  • While generally safe and effective, metformin use is associated with a rare but serious complication: metformin-associated lactic acidosis (MALA).

Observation:

  • This report details a case of a 62-year-old female patient who presented with abdominal pain, a common symptom indicative of MALA.
  • The case highlights the clinical presentation and diagnostic challenges associated with this adverse drug event.

Findings:

  • Metformin-associated lactic acidosis arises from metformin accumulation, often precipitated by factors impairing drug clearance or increasing lactate production.
  • Understanding the pathogenesis involves impaired renal function, hypoxia, and altered cellular metabolism.

Implications:

  • This case underscores the critical importance of judicious metformin prescribing, including careful patient screening for contraindications.
  • Effective management strategies for MALA are essential, focusing on early recognition, discontinuation of metformin, and supportive care.
  • Physicians must remain vigilant for MALA in patients taking metformin, especially those with risk factors.