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Metformin-Associated Lactic Acidosis in a Patient with Normal Renal Function
Ahmed Omar1, Ruth Ellen2, Alexander Sorisky3
1Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Canadian Journal of Diabetes
|May 21, 2016
Summary
Metformin-associated lactic acidosis (MALA) can occur even with normal kidney function. Discontinuing metformin resolved the lactic acidosis in a patient, highlighting its potential as a reversible cause.
Area of Science:
- Endocrinology
- Pharmacology
- Nephrology
Background:
- Type 2 diabetes mellitus management often involves metformin.
- Metformin is generally considered safe and effective, particularly in patients with normal renal function.
- Lactic acidosis is a serious complication associated with metformin use.
Observation:
- A 77-year-old female with type 2 diabetes developed lactic acidosis shortly after initiating metformin.
- The patient presented with normal renal function and no identifiable severe underlying illness.
- Lactate levels normalized within four days of discontinuing metformin.
Findings:
- Metformin-associated lactic acidosis (MALA) can occur independently of renal impairment, hypoperfusion, or severe liver disease.
- Genetic variations in metformin pharmacokinetics may contribute to MALA development.
- Metformin was identified as the likely reversible cause of lactic acidosis in this case.
Implications:
- Clinicians should consider MALA even in patients with normal renal function.
- Awareness of MALA is crucial for preventing potentially fatal toxicity associated with metformin.
- Further research into metformin pharmacokinetics may elucidate predisposition to MALA.
Keywords:
acidose lactiqueagent antihyperglycémiant oraldiabète de type 2fonction rénalelactic acidosismetforminmetformineoral antihyperglycemia agentrenal functiontype 2 diabetesMore Related Videos
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