diabetes causes

Can anyone explain the pathophysiology of diabetes mellitus as a cause lactic acidosis?

Acidosis Lactic acid is the cause most common metabolic acidosis in hospitalized patients. Is associated with an elevated anion gap and plasma lactate above 4 mEq / L. The tissue oxygenation altered, increasing anaerobic metabolism, is usually responsible for the increased production of lactate. (See "Approach to the adult with metabolic acidosis"). The pathophysiology and causes of lactic acidosis can see here. The possible role of bicarbonate therapy in these patients are treated separately. (See "therapy bicarbonate in lactic acidosis "). PATHOPHYSIOLOGY - review of the biochemistry of lactate production and metabolism is important in understanding of the pathogenesis of lactic acidosis. Both overproduction and underuse of lactate appear to be operative in most patients. Lactic acid is derived from pyruvic acid metabolism, this reaction is catalyzed by lactate dehydrogenase and involves the conversion of NADH to NAD + (reduced and oxidized adenine dinucleotide nicotine, respectively). Normal subjects produce 15 to 20 mmol / kg of lactic acid per day, generates most of them from glucose through glycolysis or the deamination of alanine [1,2]. Lactic acid is rapidly buffered, in part by extracellular bicarbonate, involves the production of lactate. In the liver and to a lesser extent in the kidney, lactate is metabolized back to pyruvate, which is then converted to either dioxide carbon and water (80 percent, in part, catalyzed by pyruvate dehydrogenase) or glucose (20 percent, in part, catalyzed by pyruvate carboxylase). Both processes result in the regeneration of bicarbonate loss in the initial buffering of lactic acid. And now meet the rest of the story!

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