Endocrinology and Metabolism

Ju Young Han (Han JY)

1 Article

Obesity and Metabolism
Metformin-Associated Lactic Acidosis: Predisposing Factors and Outcome: Min Ju Kim, Ju Young Han, Jun Young Shin, Shin Il Kim, Jeong Min Lee, Seongbin Hong, So Hun Kim, Moon Suk Nam, Yong Seong Kim; Endocrinol Metab. 2015;30(1):78-83. Published online March 27, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.1.78

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Background

Metformin is considered the first choice oral treatment for type 2 diabetes patients in the absence of contraindications. Rarely, life-threatening complications associated with metformin treatment are seen in some patients with underlying diseases. The aim of this study was to further investigate the clinical profiles and risk factors for metformin-associated lactic acidosis (MALA) and the treatment modalities according to survival.

Methods

To identify MALA, we performed a retrospective study in seven diabetic patients who were taking metformin and had been diagnosed with lactic acidosis at Inha University Hospital between 1995 and 2012. For each patient, we recorded the age, sex, daily metformin dosage, laboratory test results, admission diagnosis, and risk factors. Also, concurrent conditions, treatment modalities, and outcomes were evaluated.

Results

Six patients had risk factors for lactic acidosis before admission. All patients had renal impairment on admission as a precipitating risk factor. Five patients survived and two patients died despite early renal replacement therapy. Older patients tended to have a poorer prognosis.

Conclusion

Renal function must be monitored in elderly type 2 diabetes mellitus patients with underlying diseases and conditions causing renal impairment who begin metformin treatment. Accurate recognition of MALA and initiation of renal replacement are essential for treatment.

Citations

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