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Lactic Acidosis In Cirrhosis

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Lactic Acidosis

Background In basic terms, lactic acid is the normal endpoint of the anaerobic breakdown of glucose in the tissues. The lactate exits the cells and is transported to the liver, where it is oxidized back to pyruvate and ultimately converted to glucose via the Cori cycle. In the setting of decreased tissue oxygenation, lactic acid is produced as the anaerobic cycle is utilized for energy production. With a persistent oxygen debt and overwhelming of the body's buffering abilities (whether from chronic dysfunction or excessive production), lactic acidosis ensues. [1, 2] (See Etiology.) Lactic acid exists in 2 optical isomeric forms, L-lactate and D-lactate. L-lactate is the most commonly measured level, as it is the only form produced in human metabolism. Its excess represents increased anaerobic metabolism due to tissue hypoperfusion. (See Workup.) D-lactate is a byproduct of bacterial metabolism and may accumulate in patients with short-gut syndrome or in those with a history of gastric bypass or small-bowel resection. [3] By the turn of the 20th century, many physicians recognized that patients who are critically ill could exhibit metabolic acidosis unaccompanied by elevation of ket Continue reading >>

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  1. Mark Simpson

    (edit: it's worth pointing out that "Ketosis " on it's own is not a bad thing, but Diabetic ketoacidosis is. I assume this is the point of the question)
    Diabetic Ketoacidosis comes from High (hyper) Blood Sugar not Low (Hypo). They could happen together, if you had high blood sugar for too long, the Ketoacidosis happened then you over treated the high and it went low. In this case you'd have 2 separate problems. Hypoglaycemia and Ketoacidosis. Low blood sugar will make you pass out and go into a coma eventually. Ketoacidosis is very painful and horrible to be part of. But I wouldn't say they increase each others danger very much.
    (i am a diabetic, not a medical professional)

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  2. Dennis Kitainik

    I'm not a doctor, but from what I know of diabetic conditions, both of these can be dangerous, and especially if they occur together (especially since ketosis would probably indicate serious hypoglycemia).

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