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This dual role of lactate in modulating ferroptosis and inflammation may account for the inconsistent therapeutic outcomes associated with hypertonic sodium lactate administration in sepsis, as these effects appear to be highly dependent on factors such as timing of intervention, dosage and the specific experimental animal models employed (104,109)

Thirdly, patients with Down syndrome or autism have increased oxidative stress and exhibit particular disturbed profiles of one-carbon metabolism [1315]

Surgical interventions may be considered for select patients with advanced disease unresponsive to conservative management

Cortisol-lowering medications may have different effects on glucose metabolism, partially independent of their role in normalizing hypercortisolaemia