Severe acidosis in patients taking metformin--rapid reversal and survival despite high APACHE score.
BACKGROUND
Metformin has been shown to reduce complications and mortality from Type 2 diabetes mellitus, and is increasingly used to treat this condition. This agent is, however, associated with a rare but serious risk of lactic acidosis.


METHODS
We present cases of 10 patients with Type 2 diabetes mellitus who developed acute renal failure and severe lactic acidosis. Despite the severity of their illness, all patients but one survived.


CONCLUSIONS
The increasing prevalence of Type 2 diabetes and its treatment with metformin might result in more cases of lactic acidosis. However our case report demonstrates that early and aggressive treatment with haemofiltration can improve outcomes even in the presence of severe acidosis.
Nyirenda
M J
MJ
Metabolic Unit, Western General Hospital, Edinburgh, UK.
Sandeep
T
T
Grant
I
I
Price
G
G
McKnight
J A
JA
D018806:APACHE; D000140:Acidosis, Lactic / Q000139:chemically induced*; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000150:complications; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D004630:Emergencies; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D015996:Survival Rate
D007004:Hypoglycemic Agents; D008687:Metformin