title: Metformin-associated lactic acidosis.
abstract: : Metformin is the most commonly prescribed oral antidiabetic agent. Despite a good safety profile in most patients with diabetes, the risk of metformin-associated lactic acidosis is real if safety guidelines are ignored. Experience with 3 cases of metformin-associated lactic acidosis is reported. Two cases were caused by inappropriate use of metformin in the presence of renal, cardiac and hepatic failure and 1 case followed an intentional overdose. The literature was reviewed on the clinical presentation, prevalence, pathogenesis, prognosis and management of metformin-associated lactic acidosis. This report highlights the importance of proper patient selection, clinical and laboratory monitoring and recommendation on when to stop the drug in ambulatory and hospitalized patients to prevent this unusual but potentially lethal complication.
authors: Divisions of Endocrinology (FJP, ZH, GEU) and General Medicine (RK, AA), Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; Atlanta Heart Group (RC), Atlanta, Georgia; and Northwest Nephrology Clinic (JLP), Decatur, Georgia.
authors: Francisco J
authors: FJ
authors: Pasquel
authors: Robin
authors: R
authors: Klein
authors: Adaeze
authors: A
authors: Adigweme
authors: Ziad
authors: Z
authors: Hinedi
authors: Richard
authors: R
authors: Coralli
authors: Juan L
authors: JL
authors: Pimentel
authors: Guillermo E
authors: GE
authors: Umpierrez
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced*; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D008297:Male; D008687:Metformin / Q000009:adverse effects*; D008875:Middle Aged
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin