Observations on the relationships between plasma free fatty acids, ketones and bicarbonate in acute hyperglycaemia

Some of the initial biochemical findings, obtained from 141 randomly-selected cases of acute hyperglycaemia (admission plasma glucose > 20 mmol/L) were examined. When viewed in terms of their initial plasma bicarbonate concentration, three groups were identifiable. Plasma concentrations of free fatty acids (FFA), acetone and the sum of 3-hydroxybutyrate (3OHB) and lactate were different between these groups. However, there were no differences in plasma glucose or lactate concentrations. It was further observed that the relationship between the plasma FFA/albumin molar ratio, and ketone concentration could be described by a rectangular hyperbola, and the initial anion gap was linearly related to the sum of the 3OHB and lactate concentrations.