Analysis of Misdiagnosis and Missed Diagnosis Causes of Lactic Acidosis in Diabetes with Manifestation of Gastroin-testinal Symptoms
LIU Li-gang
ZHANG Guo-hui
ZHANG Xiao-hui
YANG Bei-zhan
Abstract：Objective To explore the clinical feature, pathogenesis of lactic acidosis in diabetes in initial period and to analyze the misdiagnosis causes in order to put forward the preventive measure. Methods Clinical data of 2 patients with lactic acidosis in diabetes misdiagnosed in the primal diagnosis was retrospectively analyzed, and related literature was also re-viewed. Results One patient visited doctors for abdominal pain, nausea and vomiting and another patient for diarrhea, vomi-ting and incomplete aphasia. One patient was misdiagnosed as having acute pancreatitis because of elevated serum amylase;the other patient was primarily diagnosed of cerebral infarction according to the brain computed tomography, which showed that lacunar cerebral infarction was missed lactic acidosis. Corresponding treatment had no significant efficacy. After the two pa-tients were admitted to our department, the blood lactate and arterial blood gas results confirmed the diagnosis of lactic acidosis in diabetes defined. After taking abundant amount of liquids, sodium bicarbonate, mechanical ventilation and the treatment of continuous venovenous hemodiafiltration, the two patients were cured. Conclusion Clinicians should improve the awareness of lactic acidosis in diabetes. Patients with diabetes with gastrointestinal symptoms, especially those with long-term use of phenformin anti-diabetic medications should be vigilant about lactic acidosis. Blood lactate examination should be taken regu-larly to prevent misdiagnosis and mistreatment.
Keywords：AcidosislacticDiabetes mellitusMisdiagnosisPancreatitisBrain infarction
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 30-33 )