Severe Metformin-Associated Lactic Acidosis-A Case Report

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.