Why Alcoholics May Have Fasting Hypoglycaemia and Gout?

• Liver cells unable to use lactate and glycerol for de novo synthesis of glucose (+ poor diet - low glycogen levels) • Reduced levels of NAD+ in liver for conversion of lactate to pyruvate and for glycerol conversion to DHAP • Increased blood lactate leads to lactic acidosis and reduces the kidney’s ability to excrete uric acid; as uric acid levels increase, crystals of urate accumulate in tissues leading to gout