Metformin-Associated Lactic Acidosis
Open accessAbstract
Metformin is a biguanide used to lower blood glucose levels in patients with non-insulin-dependent diabetes mellitus (NIDDM). Metformin notably has certain advantages over sulfonylureas because it does not cause hypoglycemia, nor does it promote weight gain or hyperinsulinemia.1 It also appears to have beneficial effects on blood lipid levels.2 Because of these advantages, metformin use is widely promoted, particularly to primary care physicians, and it will likely be used extensively in this country for treatment ofNIDDM. Nevertheless, a potential complication of metformin use is its rare association with lactic acidosis, a condition that has a mortality rate of approximately 50 percent.3,4 Accordingly, it is instructive to describe a case of metformin-associated lactic acidosis. This condition developed in a patient who had no obvious risks for lactic acidosis (eg, renal failure). Several teaching points emerge from this case report that have important implications for metformin use, including altered physiology secondary to patient comorbidity, and potential for metformin-drug interactions. This case underscores important patient considerations related to metformin prescribing.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Metformin is contraindicated in patients with heart failure due to the potential risk of developing lactic acidosis.
“Despite all its benefits, metformin is contraindicated in patients with heart failure due to the potential risk of developing lactic acidosis, a rare but potentially fatal metabolic condition resulting from severe tissue hypoperfusion [79].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [79]
Heart failure is another clinical condition associated with lactic acidosis in patients using metformin.
“Another clinical condition associated with lactic acidosis in patients using metformin is heart failure [79].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [79]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Prediction of Creatinine Clearance from Serum Creatinine
Cockcroft, D. W., & Gault, H. (2008) · The Nephron journals/Nephron journals · doi:10.1159/000180580 · Cited by 15,291 · see citing works
Clinical Practice Recommendations
Fowler, M. J. (2009) · Clinical Diabetes · doi:10.2337/diaclin.27.4.160 · Cited by 369 · see citing works
Cellular Mechanism of Action of Metformin
Klip, A., & Leiter, L. A. (1990) · Diabetes Care · doi:10.2337/diacare.13.6.696 · Cited by 238 · see citing works
Role of Metformin Accumulation in Metformin-Associated Lactic Acidosis
Lalau, J. D., Lacroix, C., Compagnon, P., Cagny, B. D., Rigaud, J. P., Bleichner, G., Chauveau, P., DULBECCO, P., Guérin, C., Haegy, J. M., et al. (1995) · Diabetes Care · doi:10.2337/diacare.18.6.779 · Cited by 184 · see citing works
Biguanide-associated lactic acidosis. Case report and review of the literature
Gan, S. C. (1992) · Archives of Internal Medicine · doi:10.1001/archinte.152.11.2333 · Cited by 129 · see citing works
Influence of oxidation polymorphism on phenformin kinetics and dynamics
Oates, N. S., Shah, R. R., Idle, J. R., & Smith, R. L. (1983) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.1983.257 · Cited by 62 · see citing works
Metformin in Noninsulin‐Dependent Diabetes Mellitus
Lee, A. J. (1996) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/j.1875-9114.1996.tb02964.x · Cited by 60 · see citing works
SCHNEIDER, J., Erren, T. C., Zöfel, P., et al. (1990) · Atherosclerosis · doi:10.1016/0021-9150(90)90148-c · Cited by 51 · see citing works
Phenformin-Induced Lactic Acidosis: A Forgotten Adverse Drug Reaction
McGuinness, M. E., & Talbert, R. L. (1993) · Annals of Pharmacotherapy · doi:10.1177/106002809302701004 · Cited by 47 · see citing works
Clinical relevance of biocompatibility.
Lalau, J. D., Lacroix, C., Cagny, B. D., & Fournier, A. (1994) · PubMed · Cited by 26 · see citing works
Improving outcomes in diabetes: a review of the outpatient care of NIDDM patients.
Cp, K. (1995) · PubMed · Cited by 19 · see citing works
Metformin and lactic acidosis — a reminder
Hutchison, S., & Catterall, J. R. (1987) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.1987.tb08089.x · Cited by 18 · see citing works
Fatal metformin induced lactic acidosis: case report.
Gowardman, J. R., & Havill, J. H. (1995) · PubMed · Cited by 15 · see citing works
Creatinine Clearance: Corrected versus Uncorrected
D'Angio, R. G., Platt, D. R., & Gannon, R. H. (1988) · Annals of Pharmacotherapy · doi:10.1177/106002808802200106 · Cited by 14 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- Schneider J, Erren T, Zofel P, Kaffarnik H. Met- formin-induced changes in serum lipids, lipopro- teins, and apoproteins in non-insulin-dependent di- abetes mellitus. Atherosclerosis 1990;82:97-103.
- Bailey C], Turner RC. Metformin. N EnglJ Med 1996;334:574-9.
- Somogyi A, Stockley C, KealJ, Rolan P, Bochner F. ~edu~ti?n ~f metformin renal tubular secretion by clmendme m man. Br J Clin PharmacoI1987;23: 545-51.
Cited by
Sorted by citations
Metformin: An Old But Still the Best Treatment for Type 2 Diabetes
Rojas, L. B. A., & Gomes, M. B. (2013) · Diabetology & Metabolic Syndrome · doi:10.1186/1758-5996-5-6 · Cited by 567 · see citing works
- Authors
- Hulisz, D. T., Bonfiglio, M. F., & Murray, R. D.
- Affiliations
- Ohio Northern University (US)
- Venue
- The Journal of the American Board of Family Medicine
- Published
- 1998-05-01
- Volume
- 11
- Issue
- 3
- Pages
- 233-236
- ISSN
- 1557-2625 (ISSN-L)
- 1558-7118
- OpenAlex
- W2326596787
- Cited by
- 17
- References
- 14
- Citations by year
- 2023: 1 · 2021: 1 · 2019: 1 · 2017: 1 · 2016: 1 · 2015: 2 · 2013: 1
- FWCI
- 0.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of the American Board of Family Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Keywords
- metformin, lactic acidosis, metformin-associated lactic acidosis, type 2 diabetes, biguanides, drug safety, drug-drug interactions, comorbidities
- MeSH terms
- Acidosis, Lactic, Aged, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Metformin, Patient Selection
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
