title: Metformin after bariatric surgery--an acid problem.
abstract: Metformin is the oral drug of first choice in type 2 diabetes. Therefore a large number of patients undergoing bariatric surgery will be on Metformin treatment. However, use of Metformin has been associated with lactate acidosis. Weight loss following bariatric surgery is most pronounced during the first weeks after the operation and this creates a phase of negative energy balance with ketone body formation. To shed more light on this situation we measured ketone bodies in 90 patients 5 days-18 months after bariatric surgery. Ketone bodies were markedly elevated during the first 3-4 months. Metformin use should therefore be critically reconsidered after bariatric operations.
authors.affiliation: Universitätsklinikum Hamburg-Eppendorf, Sektion Endokrinologie und Diabetologie, Interdisziplinäres Adipositaszentrum, Hamburg. aberle@uke.de
authors.forename: J
authors.initials: J
authors.lastname: Aberle
authors.forename: F
authors.initials: F
authors.lastname: Reining
authors.forename: V
authors.initials: V
authors.lastname: Dannheim
authors.forename: J
authors.initials: J
authors.lastname: Flitsch
authors.forename: A
authors.initials: A
authors.lastname: Klinge
authors.forename: O
authors.initials: O
authors.lastname: Mann
mesh_terms: D000143:Acids / Q000097:blood; D000328:Adult; D050110:Bariatric Surgery / Q000379:methods / Q000534:rehabilitation; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007657:Ketone Bodies / Q000097:blood*; D008297:Male; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods*; D017410:Practice Guidelines as Topic; D013997:Time Factors
chemical_list: D000143:Acids; D007004:Hypoglycemic Agents; D007657:Ketone Bodies; D008687:Metformin