I. What is lactic acidosis? Lactic acidosis is a series of symptoms caused by the increase of blood acidity due to the increase of lactic acid level in the blood for various reasons. It mainly occurs in elderly diabetic patients who take benzidine (also called hypoglycemic, must remember the name of this drug) for a long time or overdose with heart, liver and kidney diseases. Lactic acidosis generally has a rapid onset and is mainly characterized by the clinical features of metabolic acidosis of varying degrees. When blood lactic acid is significantly elevated, it can have serious effects on the central nervous, respiratory, digestive and circulatory systems. Patients with mild cases may have symptoms such as nausea, abdominal pain, decreased appetite, dizziness and drowsiness, while patients with more severe or serious conditions may have symptoms such as vomiting, deep breathing, impaired consciousness and coma. Laboratory tests may reveal elevated blood lactate levels and obvious acidosis, but elevated blood and urine ketone bodies are not obvious. Why are diabetic patients prone to lactic acidosis? 1. Diabetic patients have impaired glucose metabolism, which reduces lactic acid catabolism, so many diabetic patients usually have mild hyperlactatemia. 2. Acute complications of diabetes, such as infections and ketoacidosis, can cause further increase of lactic acid accumulation in the body and induce lactic acidosis. 3. Chronic complications of diabetes, such as combined heart, liver and kidney diseases, increased levels of glycated hemoglobin, resulting in tissue and organ hypoxia, causing increased lactic acid production; liver and kidney dysfunction can also affect the metabolism, conversion and excretion of lactic acid, leading to lactic acidosis. Under what circumstances is lactic acidosis likely to occur? 1. Diabetic patients with poor glycemic control. 2. Other acute complications of diabetes mellitus, such as various infections and ketoacidosis, can be the cause of lactic acidosis in diabetes mellitus. 3. Diseases of other important organs, such as cerebrovascular accident, myocardial infarction, etc., can aggravate poor blood perfusion in tissues and organs, leading to hypoxemia and lactic acidosis. 4. Taking large amount of hypoglycemic agents, especially hypoglycemic agents can enhance anaerobic enzymes and increase lactic acid production in vivo, so it has the effect of causing lactic acidosis. Fourth, how to prevent lactic acidosis? 1. In the process of diabetes treatment, do not take phenylephrine, hepatic and renal insufficiency, chronic hypoxic cardiopulmonary disease, and older than 70 years of age and poor cardiopulmonary function of patients, other biguanides should not be used. 2. The incidence of lactic acidosis caused by metformin is much lower than that of phenibut, so it is recommended that patients who need to be treated with metformin should choose metformin as much as possible. 3. Patients using metformin should suspend the drug and switch to insulin therapy when they encounter acute critical illness. 4. Long-term users of metformin should regularly check liver and kidney function, cardiopulmonary function, and should stop using it in time if it is not suitable for metformin. In addition, many of the so-called sugar-lowering Chinese medicine contains a large number of phenethylbiguanide drug ingredients, this drug is very easy to cause lactic acidosis, therefore, diabetic patients should not change the doctor’s prescription to take their own medication or take all kinds of sugar prescriptions to avoid diabetes lactic acidosis and other serious diseases.