Lactic Acidosis in Diabetic Population: Is Metformin Implicated? Results of a Matched Case-Control Study Performed on the Type 2 Diabetes Population of Grenoble Hospital University

Overview

Journal J Diabetes Res

Publisher Wiley

Specialty Endocrinology

Date 2016 Apr 2

PMID 27034959

Citations 7

Authors

Marion Lepelley

Joris Giai

Nassima Yahiaoui

Sebastien Chanoine

Celine Villier

Affiliations

Soon will be listed here.

Abstract

Introduction: To evaluate the strength of association between lactic acidosis (LA) and well-recognized risk factors for LA, particularly the weight of metformin.

Methods: This study is a matched case-control analysis concerning the type 2 diabetes population from Grenoble Hospital University. Cases of LA were defined biologically with pH < 7.35 and lactates > 5 mmol/L. They were matched to 2 controls defined as type 2 diabetic inpatients who did not present a LA during the study period. We performed a conditional logistic regression.

Results: We included 302 cases and 604 controls; mean age was 69.5 years (SD 11.93). Intercurrent diseases were significantly associated with LA. Chronic medical conditions had a minor impact on LA incidence, except hepatocellular dysfunction. Metformin was significantly associated with a higher LA probability in case of acute kidney injury (AKI) (OR = 1.79; p value = 0.020) but not in patients without AKI.

Discussion And Conclusions: According to this study, metformin, compared to acute medical conditions, seemed not to be associated with LA in patients with type 2 diabetes; however in case of AKI, metformin may be associated with LA.

Citing Articles

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Debate on Insulin vs Non-insulin Use in the Hospital Setting-Is It Time to Revise the Guidelines for the Management of Inpatient Diabetes?.

Pasquel F, Fayfman M, Umpierrez G Curr Diab Rep. 2019; 19(9):65.

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Risk of lactic acidosis in type 2 diabetes patients using metformin: A case control study.

Aharaz A, Pottegard A, Henriksen D, Hallas J, Beck-Nielsen H, Lassen A PLoS One. 2018; 13(5):e0196122.

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Does metformin exposure before ICU stay have any impact on patients' outcome? A retrospective cohort study of diabetic patients.

Jochmans S, Alphonsine J, Chelly J, Vong L, Sy O, Rolin N Ann Intensive Care. 2017; 7(1):116.

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