Metformin And High Uric Acid

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Investigation Of Risk Factors Affecting Lactate Levels In Japanese Patients Treated With Metformin

Metformin is a biguanaide antidiabetic drug used worldwide, and its effectiveness and benefits have already been established. However, the safety of high doses of metformin in Japanese patients, especially in elderly patients with a decreased renal function, remains unclear. Among the side effects of metformin, lactate acidosis is the most problematic due to a high mortality rate. Therefore, we assessed plasma lactate levels in metformin-treated patients to identify independent risk factors for hyperlactemia. 290 outpatients receiving various doses of metformin at our hospital were enrolled between March and July 2014. Serum electrolytes, Cre (creatinine), BUN (blood urea nitrogen), UA (uric acid), HbA1c (hemoglobin A1c), and lactate levels were investigated. Lactate levels did not significantly differ between the elderly (≥75 years) and non-elderly (<75 years) groups. Patients in the elderly group had a significantly lower daily metformin dose and estimated glomerular filtration rate (eGFR), compared with the non-elderly group (both p<0.005). Between with and without hyperlactemia groups, no significant differences were observed in either Cre or age. On the other hand, patients Continue reading >>

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Popular Questions

  1. MAO

    Seriously, gout sucks

    4 Weeks ago I developed carpal tunnel and went to the VA to see my doctor, what a nightmare to even get in to see her and when I did she says, tendinitis or sprain and then said you might have a touch of gout and then scheduled me an appointment for a rheumatologist, in MID AUGUST! I was so upset. This was a Monday after being in pain all weekend.
    So I got the number of a hand specialist because I figured who better to see than a hand specialist right. She was great, saw me on Wednesday and scheduled me for an EMG the next day to confirm the carpel tunnel and then asked me to come back to her office after since it was across the street.
    Let me add I was in pain and it was getting worse and worse every day. By this Wednesday meeting it had been just over a week since it started. It took me 5 days to get into the VA and that was such a waste of time.
    So the next day I went in for the EMG and by this time the swelling in my wrist, hand and fingers was well, stupid. This poor doctor was nice and if you have never had an EMG, they attach electrodes to you at different points and test the nerve transmission rate BUT, the bad part is, it causes contractions of muscles and twitches in fingers that well, make you cry, literally this huge man was in tears it hurt so bad. It isn't pretty when you can make someone 6'5" 280 man cry!
    I went back to see the doctor and I was prescribed Toradol and wrapped my wrist and sent home. She said nothing they could do until we got the swelling under control. Meanwhile I had a 5 gallon bucket I would fill with ice water and sit it next to my recliner in my living room and submerge my hand to almost the elbow till it was numb for pain relief. I also took the bucket to work and set it next to my chair in my office and did the same thing there.
    I could not lay down or go to bed out of shear pain and I learned to numb my hand in the ice water, then wrap it loosely in a damp hand towel and place that in a towel on my armrest so it was stay cool longer in order to get little one hour naps till it would wake me and I would dunk it again.
    Monday morning comes around and the swelling is not going away much and the pain is still unbearable. So I go in to see the specialist again and they changed me to ketorolac, stronger pain reliever and anti inflammatory. Oh and I had been taking a steroid over the weekend too.
    Now we are up to last Thursday, inflammations gone down some but not a lot. Pain is slightly better but I was still dependent on the bucket of ice water to live. So, I was then last Thursday I was prescribed. Colcrys and sent home to enjoy the weekend.
    By Saturday I was able to lay down in my bed and sleep for a couple of hours at a time and Last night, the first time in about 3 weeks I actually slept in my bed. I still have limited mobility, NO strength at all in it and as long as I do not move it much I can even find times it doesn't hurt.... much!
    The doctor called today to check up on me and asked about the upset stomach and list of issues with taking it and I told her of my improvement but I would rather have an upset stomach and runs than be in the pain I have been in for weeks. Once I get this cleared up I never want it again, any suggestions other than low protein and less fish?
    The one good thing I learned and will pass on, if you get it, get a 5 gallon bucket, it is the only thing that kept me out of the hospital.
    OK done whining!

  2. sallyb

    I am so sorry - that sounds just nasty, doctors really concern me. Our life in their hands?!
    Be safe and look after your self x

  3. Shanny

    I've had gout for years and I can say with absolute assurance that it has NEVER manifested in my hands, so are they saying that what they have diagnosed as carpal tunnel, has some connection with gout? As I understand it, gout is diagnosed by blood test for high uric acid levels - at least that's what they always check me for.
    I will also say that the flareups I used to have in my feet were every bit as painful as you describe. Red swollen throbbing foot - can't bear weight - can't bear movement. I was put on allopurinol a few years ago & haven't had a flareup since. I have tried to go easy on high purine foods, but it's hard because so many of them are low carb favorites cauliflower, chicken, tuna, salmon, spinach, etc. And since I have to watch out for high oxalate foods too, it winds up being a toss-up - I have to eat SOMETHING, so I just take my meds & hope for the best.

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