Related Experiment Videos
Fulminant lactic acidosis in two patients with Type 2 diabetes treated with metformin
R Brassøe1, T Elkmann, M Hempel
1Department of Endocrinology C, Aarhus Amtssygehus, Aarhus Universitetshospitalet, Aarhus, Denmark.
Abstract:
Lactic acidosis is a known adverse risk of metformin treatment. We report two cases in whom fulminant lactic acidosis developed during treatment. There were no contraindications to metformin treatment and both were admitted with abdominal discomfort for some days, causing dehydration. Both patients had renal failure on admission, developed multiple organ failure and both suffered a massive stroke. One patient died and the other survived but is severely disabled. We suggest, in both cases, that acute renal failure developed as a result of dehydration, causing metformin accumulation and lactic acidosis. We recommend that all patients on metformin should consider discontinuation of metformin treatment in the event of a severe medical condition causing dehydration.
Related Concept Videos
Diabetic Ketoacidosis l: Introduction
Oral Hypoglycemic Agents: Biguanides and Glitazones
Type II Diabetes II: Pathophysiology
Diabetic Ketoacidosis ll: Pathophysiology
Diabetes Mellitus: Type 2 and Gestational
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis