Published 16 September 2009, doi:10.1136/bmj.b3660
Cite this as: BMJ 2009;339:b3660

Practice

Lesson of the Week

Metformin associated lactic acidosis

¹ Dorset County Hospital, Dorchester, Dorset DT1 2JY

Dehydration in patients taking metformin can lead to metformin associated lactic acidosis, a potentially fatal condition

The first 150 words of the full text of this article appear below.

Metformin, a dimethylbiguanide, is a widely used oral antihyperglycaemic drug used in the long term treatment of type 2 diabetes mellitus. More recently it has also been used to improve fertility and weight reduction in patients with polycystic ovary syndrome.

Many large studies have shown that intensive glucose control with metformin in overweight patients with type 2 diabetes is associated with risk reductions of 32% (P=0.002) for any diabetes related end point, 42% (P=0.017) for diabetes related death, and 36% (P=0.011) for all cause mortality compared with diet alone.¹ Furthermore, metformin reduces microvascular end points, and its degree of glycaemic control is similar to that sulphonylureas and insulin. Metformin is considered to be first line treatment in overweight patients with type 2 diabetes whose blood glucose is inadequately controlled by lifestyle interventions alone and should be considered as a first line glucose lowering treatment in non-overweight patients with type 2 . . . [Full text of this article]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Article

Contraindications to the use of metformin

G C Jones, J P Macklin, and W D Alexander
BMJ 2003 326: 4-5. [Extract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

The use of central venous oxygen saturation and lactate.

Will NH Loh
bmj.com, 17 Sep 2009 [Full text]

Lactate: a function of tissue pH and rate of blood flow.

Richard G Fiddian-Green
bmj.com, 18 Sep 2009 [Full text]

NSAIDs and Angiotensin 2 Receptor Blockers

Ajith James
bmj.com, 19 Sep 2009 [Full text]

Metformin: framed again for a crime it didn't commit?

David J Preiss, et al.
bmj.com, 24 Sep 2009 [Full text]

Metformin should usually be stopped in Palliative Care.

James Gilbert
bmj.com, 25 Sep 2009 [Full text]

Online poll

Find out more here>> and here>>