Endocrine Abstracts

Background: Metabolic disturbances could contribute to poor outcome after acute myocardial infarction (AIM) in type 2 diabetic patients.

Objective: We examined the acid base disturbances that could contribute to poor prognosis after MI among type 2 diabetics suffering AMI.

Methods: Parameters of acid base status and blood lactate level were compared (using one and two – way ANOVA) in 160 age-matched individuals. Forty of them were type 2 diabetics in acute phase of MI; 40 were patients with AMI and normal blood glucose, and another 40 were type 2 diabetics with no evidence of CAD; control group consisted of 40 healthy persons. Different clinical metabolic and hormonal influences were examined in multiple correlation analysis.

Results: Blood lactate levels were significantly higher (P<0.01) in type 2 diabetics suffering AIM (DM+AIM) than in other examined groups. Blood lactate levels in DM+AIM group correlated significantly with degree of hearth insufficiency (r=41), hearth rhythm and conduction disturbances (r=0.54), CK level (r=0.68), blood glucose (r=0.46) SaO2 (r=0.68) and serum noradrenalin level (r=0.44).

Conclusion: Incidence of hyperlactatidemia in acute of myocardial infarction in type 2 diabetics is much higher than in non-diabetics with acute myocardial infarction. Stress-related diabetic ketoacidosis occurs less frequently than lactic acidosis in type 2 diabetics suffering AIM.