The Effect of Red Cell 2,3-DPG Changes Induced by Diabetic Ketoacidosis on Parameters of the Oxygen Dissociation Curve in Man

  • Eberhard Standl
  • Jørn Ditzel
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 75)


As early as in 19 39 Guest and Rapoport reported a striking decrease of the red cell 2,3-diphosphoglycerate (2,3-DPG) concentration in patients suffering from severe diabetic ketoacidosis (1). This observation has been amply confirmed in more recent years (2,3,4,5), when interest was resurrected to investigate the regulation of red cell 2,3-DPG after Benesch and Benesch (6) and Chanutin and Curnish (7) had shown the effect of 2,3-DPG on the oxygen affinity of hemoglobin. 2,3-DPG is formed as an intermediary product of red cell glycolysis; increase in hydrogen-ion concentration decreases red cell glycolysis mainly through inhibition of the phosphofructokinase step (8) and it has been widely accepted that the remarkable low erythrocyte 2,3-DPG levels in diabetic ketoacidosis — as little as 2o per cent of the normal concentration is observed — are due to this mechanism and an additional inhibition of di-phosphoglycerate mutase at lower pH (9).


Diabetic Ketoacidosis Oxygen Affinity Phosphoglycerate Mutase Plasma Inorganic Phosphate Bohr Effect 
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Copyright information

© Plenum Press, New York 1976

Authors and Affiliations

  • Eberhard Standl
    • 1
  • Jørn Ditzel
    • 1
  1. 1.Department of Medicine, Aalborg Regional Hospital, Denmark and Diabetes Research UnitCity Hospital SchwabingMunichGermany (FRG)

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