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Updated: Apr 15, 2026

Mapping Metabolism: Monitoring Lactate Dehydrogenase Activity Directly in Tissue
Published on: June 21, 2018
[Metformin-induced lactic acidosis : Severe symptoms with difficult diagnostics]
S O Decker1, M Wortmann, B H Siegler
1Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland, sebastian.decker@med.uni-heidelberg.de.
Metformin-induced lactic acidosis is a rare, severe condition. This case highlights metformin accumulation due to kidney failure, emphasizing prompt diagnosis and management in type 2 diabetes patients.
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Background:
- Metformin is a common first-line treatment for type 2 diabetes mellitus.
- Metformin-induced lactic acidosis is a rare but life-threatening complication.
- Acute kidney injury can precipitate metformin accumulation and toxicity.
Observation:
- A 64-year-old patient with type 2 diabetes presented with symptoms of metformin-induced lactic acidosis.
- The patient experienced metformin accumulation secondary to prerenal acute kidney failure.
- Clinical evaluation, diagnosis, and treatment of this rare condition were detailed.
Findings:
- Prerenal acute kidney failure was identified as the cause of metformin accumulation.
- The case underscores the severe clinical manifestations of metformin-induced lactic acidosis.
- Perioperative management guidelines for metformin were summarized.
Implications:
- Highlights the importance of monitoring renal function in patients taking metformin.
- Emphasizes the need for prompt recognition and management of metformin-induced lactic acidosis.
- Informs clinical practice regarding perioperative metformin use and potential complications.
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