Metformin Does Not Induce Hyperlactatemia in Patients Admitted to Internal Medicine Ward

Concerns about metformin-associated lactic acidosis (MALA) prohibit the use of metformin in a large subset of diabetic patients, mostly in patients with chronic kidney disease. Increasing evidence suggests that the current safety regulations may be overly restrictive. To examine the association betw...

Full description

Saved in:
Bibliographic Details
Published inThe Israel Medical Association journal Vol. 19; no. 5; pp. 300 - 303
Main Authors Koren, Shlomit, Zilberman-Itskovich, Shani, Koren, Ronit, Doenyas-Barak, Keren, Golik, Ahuva
Format Journal Article
LanguageEnglish
Published Israel 01.05.2017
Subjects
Acidosis, Lactic - chemically induced
Contraindications, Drug
Diabetes Mellitus - drug therapy
Hospitalization
Humans
Hyperlactatemia - chemically induced
Hypoglycemic Agents - adverse effects
Internal Medicine
Lactic Acid - blood
Metformin - adverse effects
Online AccessGet full text

Cover

More Information
Summary:Concerns about metformin-associated lactic acidosis (MALA) prohibit the use of metformin in a large subset of diabetic patients, mostly in patients with chronic kidney disease. Increasing evidence suggests that the current safety regulations may be overly restrictive. To examine the association between chronic metformin treatment and lactate level in acute illness on the first day of admission to an internal medicine ward. We compared diabetic and non-diabetic hospitalized patients treated or not treated with metformin in different sets of kidney function. A total of 140 patients participated in the study, 54 diabetic patients on chronic metformin treatment, 33 diabetic patients without metformin and 53 patients with no diabetes. Most participants were admitted for conditions that prohibit metformin use, such as heart failure, hypoxia and sepsis. Average lactate level was significantly higher in the diabetes + metformin group compared to the diabetes non-metformin group. Metformin treatment was not associated with higher than normal lactate level (hyperlactatemia) or low pH. No patient was hospitalized for lactic acidosis as the main diagnosis. Chronic metformin treatment mildly increases lactate level, but does not induce hyperlactatemia or lactic acidosis in acute illness on the first day of admission to an internal medicine ward. These data support the expansion of metformin use.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1565-1088