Metformin-Induced Lactic Acidosis: A Question of Time.
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ABSTRACT:
SUBMITTER: Bellefroid C
PROVIDER: S-EPMC7596499 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
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Metformin-Induced Lactic Acidosis: A Question of Time.
Bellefroid Céline C Goffin Pierre P Guntz Julien J Deville Marine M
Case reports in critical care 20201021
Metformin is an oral antidiabetic largely prescribed in the treatment of type II diabetes. Overdose is associated with life-threatening lactic acidosis. We report the case of the highest metformin concentration ever described secondary to a voluntary suicidal intake. The patient developed a severe lactic acidosis and hemodynamic shock successfully treated with high-flow hemofiltration. Time to start extrarenal epuration is capital to avoid poor evolution. ...[more]
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Project description:PurposeTo estimate the incidence of lactic acidosis (LA) and role of metformin in Japanese patients with type 2 diabetes mellitus (T2DM) treated with anti-diabetes drugs.MethodsThis retrospective propensity score matched cohort study was conducted using the Japanese Medical Data Vision claims database. T2DM patients aged 18 or above who received diabetes drugs during January 2010 through August 2014 were identified. Cases of LA were identified based on reimbursement codes and confirmed by lactic acid test and subsequent treatment by hemodialysis or intravenous sodium bicarbonate. Poisson regression and Cox proportional hazard models were used to estimate the incidence and assess if metformin use was associated with increased risk of LA.ResultsThirty cases of LA were identified among 283?491 treated T2DM patients with 504?169 patient-years of follow-up. Crude incidence of LA was 5.95 per 100?000 patient-years. T2DM patients with chronic kidney disease (CKD) were seven-fold more likely to develop LA than those without CKD (adjusted hazard ratio (aHR), 7.33, 95%CI, 3.17-16.96). Use of metformin was not associated with risk of LA in the study population (aHR, 0.92, 95%CI, 0.33-2.55), and in the propensity score matched cohort (aHR, 0.90, 95%CI, 0.26-3.11). Similar findings were observed among diabetes patients with chronic liver disease (CLD) and CKD. The age-sex adjusted incidence rates in metformin users and non-users were 5.80 and 5.78 per 100?000 person-years, respectively (Incidence rate ratio, 1.00, p?=?0.99).ConclusionsThis study found that use of metformin was not associated with increased risk of LA in diabetic patients including those with CKD or CLD. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.
| S-EPMC5089598 | biostudies-literature