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Metformin-Associated Lactic Acidosis: Predisposing Factors and Outcome
BACKGROUND: Metformin is considered the first choice oral treatment for type 2 diabetes patients in the absence of contraindications. Rarely, life-threatening complications associated with metformin treatment are seen in some patients with underlying diseases. The aim of this study was to further in...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Endocrine Society
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4384670/ https://www.ncbi.nlm.nih.gov/pubmed/25827460 http://dx.doi.org/10.3803/EnM.2015.30.1.78 |
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author | Kim, Min Ju Han, Ju Young Shin, Jun Young Kim, Shin Il Lee, Jeong Min Hong, Seongbin Kim, So Hun Nam, Moon Suk Kim, Yong Seong |
author_facet | Kim, Min Ju Han, Ju Young Shin, Jun Young Kim, Shin Il Lee, Jeong Min Hong, Seongbin Kim, So Hun Nam, Moon Suk Kim, Yong Seong |
author_sort | Kim, Min Ju |
collection | PubMed |
description | BACKGROUND: Metformin is considered the first choice oral treatment for type 2 diabetes patients in the absence of contraindications. Rarely, life-threatening complications associated with metformin treatment are seen in some patients with underlying diseases. The aim of this study was to further investigate the clinical profiles and risk factors for metformin-associated lactic acidosis (MALA) and the treatment modalities according to survival. METHODS: To identify MALA, we performed a retrospective study in seven diabetic patients who were taking metformin and had been diagnosed with lactic acidosis at Inha University Hospital between 1995 and 2012. For each patient, we recorded the age, sex, daily metformin dosage, laboratory test results, admission diagnosis, and risk factors. Also, concurrent conditions, treatment modalities, and outcomes were evaluated. RESULTS: Six patients had risk factors for lactic acidosis before admission. All patients had renal impairment on admission as a precipitating risk factor. Five patients survived and two patients died despite early renal replacement therapy. Older patients tended to have a poorer prognosis. CONCLUSION: Renal function must be monitored in elderly type 2 diabetes mellitus patients with underlying diseases and conditions causing renal impairment who begin metformin treatment. Accurate recognition of MALA and initiation of renal replacement are essential for treatment. |
format | Online Article Text |
id | pubmed-4384670 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Korean Endocrine Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-43846702015-04-07 Metformin-Associated Lactic Acidosis: Predisposing Factors and Outcome Kim, Min Ju Han, Ju Young Shin, Jun Young Kim, Shin Il Lee, Jeong Min Hong, Seongbin Kim, So Hun Nam, Moon Suk Kim, Yong Seong Endocrinol Metab (Seoul) Original Article BACKGROUND: Metformin is considered the first choice oral treatment for type 2 diabetes patients in the absence of contraindications. Rarely, life-threatening complications associated with metformin treatment are seen in some patients with underlying diseases. The aim of this study was to further investigate the clinical profiles and risk factors for metformin-associated lactic acidosis (MALA) and the treatment modalities according to survival. METHODS: To identify MALA, we performed a retrospective study in seven diabetic patients who were taking metformin and had been diagnosed with lactic acidosis at Inha University Hospital between 1995 and 2012. For each patient, we recorded the age, sex, daily metformin dosage, laboratory test results, admission diagnosis, and risk factors. Also, concurrent conditions, treatment modalities, and outcomes were evaluated. RESULTS: Six patients had risk factors for lactic acidosis before admission. All patients had renal impairment on admission as a precipitating risk factor. Five patients survived and two patients died despite early renal replacement therapy. Older patients tended to have a poorer prognosis. CONCLUSION: Renal function must be monitored in elderly type 2 diabetes mellitus patients with underlying diseases and conditions causing renal impairment who begin metformin treatment. Accurate recognition of MALA and initiation of renal replacement are essential for treatment. Korean Endocrine Society 2015-03 2015-03-27 /pmc/articles/PMC4384670/ /pubmed/25827460 http://dx.doi.org/10.3803/EnM.2015.30.1.78 Text en Copyright © 2015 Korean Endocrine Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Min Ju Han, Ju Young Shin, Jun Young Kim, Shin Il Lee, Jeong Min Hong, Seongbin Kim, So Hun Nam, Moon Suk Kim, Yong Seong Metformin-Associated Lactic Acidosis: Predisposing Factors and Outcome |
title | Metformin-Associated Lactic Acidosis: Predisposing Factors and Outcome |
title_full | Metformin-Associated Lactic Acidosis: Predisposing Factors and Outcome |
title_fullStr | Metformin-Associated Lactic Acidosis: Predisposing Factors and Outcome |
title_full_unstemmed | Metformin-Associated Lactic Acidosis: Predisposing Factors and Outcome |
title_short | Metformin-Associated Lactic Acidosis: Predisposing Factors and Outcome |
title_sort | metformin-associated lactic acidosis: predisposing factors and outcome |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4384670/ https://www.ncbi.nlm.nih.gov/pubmed/25827460 http://dx.doi.org/10.3803/EnM.2015.30.1.78 |
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