[ Diabetes Type 2 ]

[Metformin-associated lactic acidosis with acute renal failure in type 2 diabetes mellitus]. – PubMed

Lactic acidosis is a serious medical condition in which too much lactate builds up in the body, resulting in an excessively low pH. The aim of this study was to identify causes of lactic acidosis in this group of patients and to measure the extent of metabolic disturbances based on the available laboratory test results. Food and Drug Administration, Rockville, Maryland. Lactic Acidosis and Exercise: What You Need to Know – WebMD Lactic acidosis occurs when lactic acid accumulates in the bloodstream. The United Kingdom Prospective Diabetes Study demonstrated impressive reductions in diabetes-related endpoints and mortality in overweight patients with type 2 diabetes who used this drug [3]. Patients with normolactatemia and hyperlactatemia were similar in terms of metformin dosage and laboratory parameters. The biochemical indexes included creatinine (Cr) and hepatase were measured with enzymatic procedures.

Correlation studies showed a positive correlation between serum creatinine and plasma metformin and between plasma metformin and arterial lactate but, for the latter correlation, only in patients with metformin accumulation. When oxygen levels decrease at the muscle, then energy production must switch from “aerobic” (with oxygen) to “anaerobic” (without oxygen) metabolism and therefore lactic acid levels rise. After 8 hours of hemodialysis the acid-base metabolism was almost balanced and the vigilance of the patient normalized. No further sessions of hemodialysis were needed and insulin therapy was started. Metformin-induced lactic acidosis is a common side effect in patients with renal insufficiency. Clinical studies have shown that people who are diabetic or pre-diabetic are lacking in certain nutrients and taking the correct supplements can quickly help fix this and get you faster results. First-line therapy for correction of lactic acidosis and effective elimination of metformin is bicarbonate hemodialysis.

Sodium bicarbonate infusions are not able to correct the acid-base metabolism sufficiently. For prevention the renal function should be monitored closely and metaformin therapy should be stopped, if a deterioration of renal function is observed.

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