ABSTRACT
BACKGROUND: Metformin-associated lactic acidosis (MALA) is a widely documented adverse event of metformin. Despite being considered one of the main causes of metabolic acidosis, the association between an anion gap and MALA diagnosis is still uncertain. CASE PRESENTATION: Cases involving six Caucasian patients with suspected MALA who were admitted to the emergency department were analysed. All these patients presented with pH values < 7.35, lactate levels > 2 mmol/L, and estimated glomerular filtration < 30 mL/min. Metformin plasma concentrations were > 2.5 mg/L in all the patients. The highest metformin concentrations were not found in the patients with the highest lactate levels. The anion gap values ranged from 12.3 to 39.3, with only two patients exhibiting values > 14. CONCLUSIONS: In patients with MALA, there is a significant variability in the anion gap values, which is not related to the level of metformin accumulation, and therefore, it is doubtful whether measuring anion gaps is useful as an approach for MALA diagnosis.
Subject(s)
Acid-Base Equilibrium , Acidosis, Lactic/diagnosis , Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/adverse effects , Metformin/adverse effects , Acidosis, Lactic/blood , Acidosis, Lactic/chemically induced , Aged , Aged, 80 and over , Anions/blood , Cations/blood , Female , Humans , Lactic Acid/blood , Male , Metformin/blood , Middle AgedABSTRACT
No disponible
Subject(s)
Humans , Chronic Disease/epidemiology , Primary Health Care/organization & administration , Facilities and Services Utilization/statistics & numerical data , Delivery of Health Care/organization & administration , Risk Assessment/statistics & numerical data , Aging , Continuity of Patient Care/trendsABSTRACT
No disponible
Subject(s)
Humans , Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/standards , Diabetes Mellitus/epidemiology , Hypoglycemia/drug therapy , Critical Care/standards , Clinical CompetenceABSTRACT
No disponible
Subject(s)
Humans , Diabetes Mellitus/drug therapy , Hyperglycemia/drug therapy , Hypoglycemic Agents/administration & dosage , Diabetes Mellitus/epidemiology , Pulse Therapy, Drug/methods , Emergency Treatment/methodsSubject(s)
Emergency Service, Hospital , Hyperglycemia/drug therapy , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Clinical Protocols , Drug Administration Schedule , Humans , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Practice Guidelines as TopicABSTRACT
No disponible
