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If NADH is not reoxidized by methemoglobin, however, pyruvate is reduced in the lactate dehydrogenase (LDH) step, forming lactate as the final end product of glucose metabolism

"The pathobiology of diabetic complications: A unifying mechanism"

doi: 10.1016/j.bbi.2019.04.037

Likely, this could be the extended NO-system involvement (with the gastric lesions, despite inconsistencies, L-arginine has a beneficial effect, while L-NAME has an ulcerogenic effect (8, 36)), they were far less investigated in duodenal lesions (16, 17)