Diabetic medicine : a journal of the British Diabetic Association
-
Comparative Study
Clinical characteristics and outcome of hyperglycaemic emergencies in Johannesburg Africans.
In this prospective analysis we investigated the clinical characteristics of black South African diabetic patients admitted to hospital with hyperglycaemic emergencies. The study cases were selected from the medical admissions to an urbanized, Johannesburg academic hospital over a period of 12 months. Only patients with severe diabetic ketoacidosis (DKA) or hyperosmolar non-ketotic hyperglycaemia (HNKH) as defined in the text were included. ⋯ Infection was the leading precipitating factor for both DKA and HNKH, followed by first presentation and noncompliance. We conclude that the majority of urban African patients admitted to hospital with DKA have NIDDM. Mortality from DKA among the black Africans in Johannesburg is low and comparable to the mortality in western Europe.
-
Randomized Controlled Trial Clinical Trial
Metformin and exercise: no additive effect on blood lactate levels in health volunteers.
Metformin administration has been associated with substantial rises in blood lactate concentrations in individual Type 2 diabetic patients. Exercise also leads to increases in blood lactate levels. The objective of this study was to determine whether metformin administration augments the rise in plasma lactate concentrations during intermittent exercise in healthy subjects, when compared to placebo. ⋯ On the morning of the fourth day exercise was performed on an upright bicycle ergometer at a work load of 200 W for 2 min alternating with 2 min rest for an overall duration of 60 min. Maximal plasma lactate levels during exercise (metformin: 4.1 +/- 2.6 mmol l(-)1, placebo: 4.5 +/- 2.6 mmol (l-1)), areas under the plasma lactate curve (207 +/- 121 vs 222 +/- 133 mmol l(-1) h(-1), blood pyruvate levels at the end of exercise (0.06 +/- 0.04 vs 0.07 +/- 0.04 mmol l(-1)), lactate/pyruvate ratio (65 +/- 41 vs 60 +/- 36), serum insulin (25.4 +/- 8.9 vs 32.3 +/- 13.0 pmol l(-1)), and plasma glucose (4.4 +/- 0.3 vs 4.5 +/- 0.3 mmol l(-1)) did not differ significantly between metformin and placebo administration. Administration of metformin did not lead to an augmented rise in endogenous plasma lactate concentrations during intermittent exercise in healthy fasting subjects under the experimental design chosen.