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Lactate Levels in Diabetic Patients on Oral Hypoglycemic Drugs

Aparna Misra, Professor and Head, Department of Biochemistry, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh 226003, India , Pranjalika Mishra1 , Rachna Ahuja2 , Rumana Ahmad3 , Tanvir Jafri4 , Aparna Misra5

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Indian Journal of Pathology: Research and Practice 7(10):p 1089-1094, October 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.71018.8

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Abstract

 L-lactate is the end product of anaerobic glycolysis. It is derived predominantly from white skeletal muscle, brain, skin, renal medulla and erythrocytes. Lactate dehydrogenase catalysis the reduction of pyruvate to lactate. There are two major clinical settings in which lactic acidosis occur: (1) Conditions associated with hypoxia e.g. shock, congestive heart failure, myocardial infarction, blood loss and pulmonary edema. (2) Metabolic or drug/toxin related disorders like diabetes mellitus, hepatic disease and neoplasia. Objective of study is to find out the variation of lactate level in diabetic patient taking hypoglycemic drugs and also the correlation between fasting blood glucose and lactate in diabetic patients. It is an observational study in which 50 control subjects (fasting blood sugar 110 mg/dl) considered as case, all diabetics irrespective of treatment (OHA/Insulin). Age group 35-70 yrs. Lactate level ≤1.9 taken as normal. Lactate level among control group found to be 1.12±0.18 (mean±SD) with fasting blood sugar level found to be 92.99±5.64 (mean ± SD). In control group lactate level among control group found to be 2.03±0.23 (mean±SD) with fasting blood sugar level found to be 115.28±2.83 (mean±SD). The two-tailed pvalue is less than 0.0001. By conventional criteria, this difference is considered to be extremely statistically significant. In this, the lactate level found to be 2.03±0.23 among case group. This study also shows that after using metformin some individuals have fasting blood sugar more than 110 mg/dl 115.28±2.83.There is slight increase in lactate level among case group 2.03±0.23 These observations suggest that accumulation of metformin may not be as significant with respect to high arterial levels of lactate. 

Keywords: Diabetes Mellitus; Blood Sugar Level; Metformin; Lactate Level; Lactic Acidosis.

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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.71018.8

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