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Area of Science:

  • Endocrinology
  • Nephrology
  • Critical Care Medicine

Background:

  • Metformin is a first-line oral hypoglycemic agent for type 2 diabetes mellitus.
  • Metformin-associated lactic acidosis (MALA) is a rare but severe adverse effect.
  • Lactic acidosis can lead to multi-organ failure and death.

Purpose of the Study:

  • To review the pathophysiology, clinical presentation, and management of metformin-associated lactic acidosis.
  • To emphasize the importance of early recognition and intervention for improved patient outcomes.
  • To highlight the role of hemodialysis in MALA treatment.

Main Methods:

  • Literature review of MALA cases and treatment guidelines.
  • Analysis of diagnostic criteria and therapeutic strategies.
  • Case study review focusing on outcomes related to treatment timeliness.

Main Results:

  • MALA is characterized by elevated serum lactate levels and metabolic acidosis.
  • Risk factors include renal impairment, acute illness, and drug overdose.
  • Hemodialysis is highly effective in clearing metformin and lactate, improving survival rates.

Conclusions:

  • Early diagnosis of MALA is critical for effective management.
  • Prompt initiation of hemodialysis and supportive care significantly reduces mortality.
  • Awareness of MALA among healthcare providers is essential for safe metformin use in diabetes management.