585-P: Lactate Kinetics in Type 1 Diabetes—A 1-13C Lactate Study

Abstract

Lactate kinetics in individuals with type 1 diabetes (T1D) has not been assessed quantitatively. Defining lactate kinetics in T1D under steady state condition is vital for estimating non-steady state lactate turnover. We studied 5 T1D and 7 nondiabetic (ND) anthropometrically matched participants during [1-13C]-sodium-lactate bolus injection in the resting, overnight fasted state. A two-compartment model with loss only from the peripheral compartment reliably described [1-13C]-lactate kinetics. Volume of distribution of the accessible compartment, V1, was similar between T1D and ND groups (40.32±21.08 vs. 47.64±33.32 mL/kg, p=0.76) thus concordant to plasma volume (~40 ml/kg). The irreversible loss from the peripheral compartment was impaired in T1D vs ND (0.08±0.03 vs. 0.13±0.03 min−1, p=0.03); rate of lactate appearance (12.4±5.2 vs. 18.5±9.6 µmol/kg/min, p=0.34), disappearance (12.7±5.2 vs. 18.8±9.7 µmol/kg/min, p=0.34) and lactate clearance (15.9±4.7 vs. 21.9±7.8 mL/kg/min, p=0.20) were numerically but not statistically lower in T1D vs. ND individuals. To conclude, we have defined lactate kinetics under resting, overnight fasted state in T1D and ND subjects. While the volume of distribution was similar in both groups, irreversible loss from the peripheral compartment was lower in T1D subjects. Further studies are needed to better define lactate kinetics during exercise in individuals with and without T1D. Disclosure D.Romeres: None. F.Ruchi: None. Y.Yadav: None. C.Cobelli: None. A.Basu: None. R.Basu: Consultant; Sparrow Pharmaceuticals Inc, Research Support; Abbott Diabetes, AstraZeneca. Funding National Institutes of Health (DK29953 to R.B.), (DK85516 to A.B.)