What is a secondary source of acid-base problems that result from insufficienr insulin and how does it occur?
Lactic acid increases, causing more metabolic acidosis. It results from the dehydration that occurs with diabetes that leads to hemo-concentration, hypovolemia, hyperviscosity, hypoperfusion of tissues, and hypoxia, especially to the brain. Hypoxic cells do not metabolize glucose efficiently, the Krebs' cycle is blocked, and lactic acid results from the anerobic metabolism of glucose in cells that do not need insulin to get glucose acroos the cell membrane. (Remember - not all cell types require insulin, e.g. brain, liver & blood.)