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151557 - lactic acidosis and the relationship with metformin usage.pdf (184.8 kB)

Lactic acidosis and the relationship with metformin usage: Case reports

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journal contribution
posted on 2023-05-21, 10:17 authored by Huang, W, Ronald CastelinoRonald Castelino, Gregory PetersonGregory Peterson

Aims: The principal objective of this study was to retrospectively review a series of cases of lactic acidosis (LA) in patients with type 2 diabetes mellitus (T2DM) and examine the relationship with the use of metformin. More generally, the study enabled an investigation of the profiles of patients diagnosed with LA and clinical variables associated with in-hospital mortality.

Methods: All patients admitted to the Royal Hobart Hospital in Tasmania with LA (lactate >5.0 mmol/L and pH <7.35) over a 4-year period were included. Data extracted included patient demographics, medical history, medications, acute and chronic conditions associated with LA, and relevant pathology results. Multivariate logistic regression analysis was used to identify predictors for in-hospital mortality in patients with LA.

Results: A total of 139 patients with LA were included in this study. Of these, 23 patients had T2DM and 11 patients were taking metformin. All metformin-treated patients had at least 1 additional medical condition (either chronic or acute) associated with an increased risk for LA. More than half (n = 72, 51.8%) of the patients with LA died during hospitalization. Multivariate logistic regression revealed older age and lower pH as the significant independent predictors (P < 0.05) for in-hospital mortality.

Conclusion: LA was associated with high in-hospital mortality, with older age and lower pH as the significant risk factors for mortality. In patients with LA, approximately half of the patients with T2DM were receiving metformin. All the patients treated with metformin had other medical conditions that were risk factors for developing LA. The role of LA in patients treated with metformin is seemingly overemphasized.


Publication title

Medicine (United States)










School of Pharmacy and Pharmacology


Lippincott Williams & Wilkins

Place of publication

United States

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Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CC BY-NC 4.0), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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Treatment of human diseases and conditions

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