title: The Dramatic Recovery of a Patient with Biguanide-associated Severe Lactic Acidosis Following Thiamine Supplementation.
abstract: Biguanides are a drug of choice for the treatment of type 2 diabetes mellitus. Although they can cause lactic acidosis in susceptible patients with predisposing risk factors, the incidence of lactic acidosis is reported to be very low when they are used properly. We herein present a case of biguanide-associated severe lactic acidosis complicated with thiamine deficiency that was provoked without predisposing factors for thiamine deficiency. Diabetic patients taking biguanide may be predisposed to thiamine deficiency, even when there is no evidence of risk factors, and the high-dose administration of thiamine may be essential in the treatment of this otherwise under-recognized disorder.
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Godo
authors.forename: Yoshitaro
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Motoo
authors.initials: M
authors.lastname: Fujita
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kudo
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Nomura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimokawa
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kushimoto
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced / Q000188:drug therapy* / Q000209:etiology; D000368:Aged; D001645:Biguanides / Q000009:adverse effects* / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D013831:Thiamine / Q000627:therapeutic use*; D013832:Thiamine Deficiency / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy
chemical_list: D001645:Biguanides; D007004:Hypoglycemic Agents; D013831:Thiamine