eCite Digital Repository

Lactic acidosis and the relationship with metformin usage: Case reports


Huang, W and Castelino, RL and Peterson, GM, Lactic acidosis and the relationship with metformin usage: Case reports, Medicine (United States), 95, (46) pp. 1-5. ISSN 0025-7974 (2016) [Refereed Article]

PDF (Published version)

Copyright Statement

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.

DOI: doi:10.1097/MD.0000000000004998


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.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacology and therapeutics
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Huang, W (Miss Weiyi Huang)
UTAS Author:Castelino, RL (Dr Ronald Castelino)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
ID Code:151557
Year Published:2016
Web of Science® Times Cited:8
Deposited By:Pharmacy
Deposited On:2022-08-01
Last Modified:2022-09-30
Downloads:1 View Download Statistics

Repository Staff Only: item control page