Summary:The recovery of weanling mice from insulin induced hypoglycemic stupor-coma after injection of so dium -L( + )-lactate (18 mmoUkg) was as rapid (10 min) as in litter-mates treated with glucose (9 mmoUkg). Stimu lated by this dramatic action, we studied the effects of lactate injection on brain carbohydrate and energy me tabolism in normal and hypoglycemic mice; blood and liver tissue were also studied. Te n minutes after lactate injection in normal mice, plasma lactate levels increased by 15 mmoUL; plasma glucose levels were unchanged, but the f3-hydroxybutyrate concentration fell 59%. In the brains of these animals, glucose levels increased 2.3-fold, and there were significant increases in brain glycogen (10%), glucose-6-phosphate (27%), lactate (68%), pyru vate (37%), citrate (12%), and malate (19%); the increase in (I-ketoglutarate (32%) was not significant. Lactate in jection reduced the cerebral glucose-use rate 40%. These changes were not due to lactate-induced increases in blood [HCO 31 and pH (examined by injection of 15There is increasing interest in lactate as an oxi dizable fuel for brain metabolism, particularly in de veloping animals. In 1971, Oldendorf demonstrated a specific carrier for transport of lactate (and other monocarboxylic acids) across the blood-brain bar rier. Vannucci and Duffy (1976) were the first to suggest that lactate might serve as a fuel for brain Preliminary data from this study were presented to the Child Neurology Society, Salt Lake City, Utah, U.S. A., 1982, and 498 mmoUkg sodium bicarbonate). Although lactate injection of hypoglycemic mice doubled levels of glucose in plasma and brain (not significant) and most of the cerebral gly colytic intermediates, values were far below normal (still in the range seen in hypoglycemic animals). By contrast, citrate and a-ketoglutarate levels returned to normal; the large increase in malate was not significant. Reduced glu tamate levels increased to normal, and elevated aspartate levels fell below normal. Thus, recovery from hypogly cemic stupor does not necessarily depend on normal levels of plasma and/or brain glucose (or glycolytic inter mediates). Near normal levels of the Krebs citric acid cycle intermediates suggest that changes in these metab olites, amino acids, or derived substrates relate to the dramatic recovery of hypoglycemic mice after lactate in jection. Key Words: Brain lactate transport-Cerebral bicarbonate metabolism-Cerebral lactate metabolism Insulin hypoglycemia-Response of hypoglycemia to lactate-Suckling-weanling mice. metabolism in immature rats. Following injection of L-[U-14 C]lactate in anoxic fetal and newborn rats they noted a progressive increase in brain radioac tivity; during recovery from anoxia, pyruvate levels increased sharply but lactate concentration re mained high and brain glucose rose above the con trol value. Based on these findings, the authors pos tulated that during recovery, lactate was oxidized to pyruvate and that there was a continued influx of lactate from the blood with sparin...