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April 6, 1963

Special Communication

JAMA. 1963;184(1):47. doi:10.1001/jama.1963.03700140103015

Lactic Acidosis in Diabetes Mellitus  An ACCUMULATION OF LACTIC ACID in the L blood, sufficient to decrease the serum bicarbonate and the pH, has been observed in both diabetic and nondiabetic patients. The significance of this was discussed on Nov 17, 1962, during a conference in New York on nonketotic metabolic acidosis in diabetes mellitus. The conclusions reached are herein summarized.Lactic acidosis is a group of syndromes for which Huckabee's classification (Amer J Med30:833, 840, 1961) provides a useful frame of reference.

Type I.  —Lactic acid (L) is slightly increased above the basal value of approximately 1 mM/liter in venous blood and there is a proportionate percentage increase in pyruvic acid (P) with maintenance of the usual 10:1 L/P ratio. This has been observed in patients who are hospitalized because of miscellaneous diseases and can be produced in patients or healthy subjects by muscular tension, exercise, hyperventilation,

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