Hyperlactatemia in diabetic ketoacidosis

Area of Science:

• Endocrinology
• Metabolic Disorders
• Clinical Chemistry

Background:

• Diabetic ketoacidosis (DKA) is a serious complication of diabetes.
• Lactate elevation is frequently observed in DKA, but its predictors and patterns require further clarification.

Purpose of the Study:

• To determine the prevalence and degree of lactate elevation in DKA.
• To identify biochemical factors predicting L-lactate levels in DKA patients.

Main Methods:

• Retrospective review of 79 DKA patient episodes.
• Univariate and multivariate linear regression analyses to predict lactate levels based on biochemical variables.

Main Results:

• Mean lactate level was 3.05 mmol/L, with 65% of patients exceeding 2 mmol/L.
• Higher lactate levels correlated with increased hydrogen ion concentration, higher blood glucose, and lower estimated glomerular filtration rate.
• Bicarbonate, beta-hydroxybutyrate, BMI, MAP, and osmolality did not significantly predict lactate levels.

Conclusions:

• Elevated lactate is characteristic of DKA.
• Blood glucose and hydrogen ion concentration are key predictors of lactate levels in DKA.
• Lactate levels exhibit diverse patterns of decline during DKA treatment.