Cerebrospinal fluid lactate in patients with diabetes mellitus and hypoglycaemic coma

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 52; no. 3; pp. 372 - 375
• Main Authors: Yao, H, Sadoshima, S, Nishimura, Y, Fujii, K, Oshima, M, Ishitsuka, T, Fujishima, M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.03.1989; BMJ; BMJ Publishing Group LTD
• Subjects: Associated diseases and complications; Biological and medical sciences; Brain Damage, Chronic - cerebrospinal fluid; Diabetes Mellitus - cerebrospinal fluid; Diabetes. Impaired glucose tolerance; Diabetic Coma - cerebrospinal fluid; Diabetic Neuropathies - cerebrospinal fluid; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Hypoglycemia - cerebrospinal fluid; Insulin Coma - blood; Lactates - cerebrospinal fluid; Lactic Acid; Male; Medical sciences; Middle Aged; Pyruvates - cerebrospinal fluid; Pyruvic Acid; Coma; Endocrinopathy; Human; Lactates; Insulin dependent diabetes; Cerebrospinal fluid; Hypoglycemia
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.52.3.372

Cerebrospinal fluid (CSF) lactate and pyruvate concentrations were determined in 20 patients with diabetes mellitus but without disturbance of consciousness and five who recovered from hypoglycaemic coma. CSF lactate was slightly but significantly higher in diabetes mellitus (1.78, SEM 0.04 m mol/l) than that in 15 control subjects (1.40, SEM 0.05 m mol/l). In those who recovered from hypoglycaemic coma, CSF lactate was markedly elevated to 2.45-4.43 m mol/l. CSF glucose concentrations, however, were substantially the same between treated hypoglycaemic and diabetes mellitus groups. These findings indicate that CSF lactate levels increase with glycaemic levels in diabetes mellitus owing to enhanced glucose influx into glycolytic pathway of the brain, and also increases in treated hypoglycaemic coma probably due to mitochondrial dysfunction or damage.