title: Lactic Acidosis in Diabetic Population: Is Metformin Implicated? Results of a Matched Case-Control Study Performed on the Type 2 Diabetes Population of Grenoble Hospital University.
abstract: BACKGROUND
  To evaluate the strength of association between lactic acidosis (LA) and well-recognized risk factors for LA, particularly the weight of metformin.
  
  
  METHODS
  This study is a matched case-control analysis concerning the type 2 diabetes population from Grenoble Hospital University. Cases of LA were defined biologically with pH < 7.35 and lactates > 5 mmol/L. They were matched to 2 controls defined as type 2 diabetic inpatients who did not present a LA during the study period. We performed a conditional logistic regression.
  
  
  RESULTS
  We included 302 cases and 604 controls; mean age was 69.5 years (SD 11.93). Intercurrent diseases were significantly associated with LA. Chronic medical conditions had a minor impact on LA incidence, except hepatocellular dysfunction. Metformin was significantly associated with a higher LA probability in case of acute kidney injury (AKI) (OR = 1.79; p value = 0.020) but not in patients without AKI.
  
  
  CONCLUSIONS
  According to this study, metformin, compared to acute medical conditions, seemed not to be associated with LA in patients with type 2 diabetes; however in case of AKI, metformin may be associated with LA.
authors.affiliation: Centre Régional de Pharmacovigilance, Pôle Santé Publique, Centre Hospitalier Universitaire de Grenoble, 38000 Grenoble, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Lepelley
authors.affiliation: Service de Biostatistique des Hospices Civils de Lyon, 69002 Lyon, France; Laboratoire Biostatistique Santé, UCBL, Equipe de l'UMR CNRS 5558, 69495 Pierre-Bénite Cedex, France.
authors.forename: Joris
authors.initials: J
authors.lastname: Giai
authors.affiliation: Centre Régional de Pharmacovigilance, Pôle Santé Publique, Centre Hospitalier Universitaire de Grenoble, 38000 Grenoble, France.
authors.forename: Nassima
authors.initials: N
authors.lastname: Yahiaoui
authors.affiliation: Pôle Pharmacie, Centre Hospitalier Universitaire de Grenoble, 38000 Grenoble, France; Université Grenoble Alpes, 38000 Grenoble, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Chanoine
authors.affiliation: Centre Régional de Pharmacovigilance, Pôle Santé Publique, Centre Hospitalier Universitaire de Grenoble, 38000 Grenoble, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Villier
mesh_terms: D000140:Acidosis, Lactic / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D058186:Acute Kidney Injury / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008687:Metformin / Q000009:adverse effects*; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007004:Hypoglycemic Agents; D019344:Lactic Acid; D008687:Metformin