INCREASED SERUM D-LACTATE ASSOCIATED WITH DIABETIC-KETOACIDOSIS

We hypothesized that serum D-lactate may be increased in vivo in diabe tes mellitus as a result of increased glucose flux through the glyoxal ase pathway and/or via hepatic ketone metabolism. Levels of D-lactate and related metabolic intermediates were measured in 30 cats with spon taneous diabetes mellitus and in one ketoacidotic nondiabetic cat. Ser um D-lactate was significantly (P = .0051) elevated in cats with ketoa cidosis (337.2 +/- 70.2 mu mol/L) as compared with nonketoacidotic dia betic (140.3 +/- 58.8) and control (25.0 +/- 6.5) cats. Two nonketoaci dotic cats also had high levels of D-lactate. There was a significant linear correlation (r = .684, P = .0001) between D-lactate and beta-hy droxybutyrate concentrations. Serum D-lactate did not correlate with s erum glucose (r = .078, P = .6825), and in vitro erythrocyte D-lactate formation did not increase in the presence of hyperglycemia. These da ta suggest that hepatic ketone metabolism, rather than hyperglycemia, may be a major source of serum D-lactate in diabetics. Copyright (C) 1 995 by W.B. Saunders Company