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Elevated cardiac ferroptosis markers in heart failure patients with diabetes Decreased myocardial GPX4 expression and activity in diabetic heart failure patients According to guidelines for evaluating myocardial cell death, diminished expression of glutathione peroxidase-4 (GPX4), a lipid-specific antioxidant, serves as a pivotal indicator of ferroptosis [15]

Holmay et al

In addition, D-lactate can also be produced by gut microbes (such as Lactobacillus ) that breakdown glucose to produce D-lactate, which is absorbed through the gut and into the blood

British National Formulary (BNF) (65 ed.)