title: Metformin-associated lactic acidosis in Chinese patients with type II diabetes.
abstract: Metformin is a widely used antidiabetic agent that is generally considered safe. However, metformin-associated lactic acidosis (MALA), though not common, occurs from time to time and results in significantly high mortality. A series of 23 MALA cases in a local major hospital in Hong Kong is reported in this article to demonstrate the epidemiological data, risk factors, clinical features as well as the clinical outcomes for better understanding of this disease entity. It is the first MALA case series in which plasma metformin levels were assessed. However, the results show that plasma metformin levels in MALA bear no diagnostic and prognostic values. Risk factors of mortality were identified as shock and high plasma lactate levels. The majority of patients were found to have significantly raised creatinine versus a normal baseline value before the acute illness. Concomitant illnesses taking place alongside MALA were common. With a high utility rate of renal replacement therapy (82.6%) in the study group, the mortality rate was 30.4%.
authors: Division of Clinical Biochemistry, Queen Mary Hospital, Hong Kong, SAR, China. ycw186 @ ha.org.hk
authors: Chun Wing
authors: CW
authors: Yeung
authors: Ho Yin
authors: HY
authors: Chung
authors: Bonnie Mei Wah
authors: BM
authors: Fong
authors: Nga Wing
authors: NW
authors: Tsai
authors: Wai Ming
authors: WM
authors: Chan
authors: Tak Shing
authors: TS
authors: Siu
authors: Sidney
authors: S
authors: Tam
authors: Sik Hon
authors: SH
authors: Tsui
mesh_terms: D000140:Acidosis, Lactic / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood; D044466:Asian People; D002681:China / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D062787:Drug Overdose; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000097:blood; D007674:Kidney Diseases / Q000453:epidemiology; D008297:Male; D008687:Metformin / Q000009:adverse effects* / Q000097:blood; D008875:Middle Aged; D017582:Renal Replacement Therapy; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin; D003404:Creatinine; D000681:Amylases