diabetestalk.net

How To Prevent Lactic Acidosis When Taking Metformin

Share on facebook

in this videoclip dr. Pietro Addamo and dr Simona Polemi illustrate metabolic and pathophysiological pathways that lead to lactic acidosis caused by metformin. The short video ends with a case report.

Mala: Metformin-associated Lactic Acidosis

By Charles W. O’Connell, MD Introduction Metformin is a first-line agent for type 2 diabetes mellitus often used as monotherapy or in combination with oral diabetic medications. It is a member of the biguanide class and its main intended effect is expressed by the inhibition of hepatic gluconeogenesis. In addition, metformin increases insulin sensitivity, enhances peripheral glucose utilization and decreases glucose uptake in the gastrointestinal tract. Phenformin, a previously used biguanide, as withdrawn from the market in the 1970’s due its association with numerous cases of lactic acidosis. Metformin is currently used extensively in the management of diabetes and is the most commonly prescribed biguanide worldwide. The therapeutic dosage of metformin ranges from 850 mg to a maximum of 3000 mg daily and is typically divided into twice daily dosing. It is primarily used in the treatment of diabetes but has been used in other conditions associated with insulin resistance such as polycystic ovarian syndrome. MALA is a rare but well reported event that occurs with both therapeutic use and overdose states. Case presentation A 22-year-old female presents to the Emergency Departmen Continue reading >>

Share on facebook

Popular Questions

  1. 2blessed4stress

    metformin and lactic acidosis

    I am hoping that I can get some guidance from the members here. There are many of you that have a wealth of information on diabetes and things related so please bear with me. I went to the doctor yesterday and finally asked her for metformin er and was all set to try it out. Then I read the paper that came with it from the pharmacy. The warning about lactic acidosis stopped me in my tracks. Now I am afraid to take it. I searched the posts her a DD about lactic acidosis and I also found that some members said it caused them to be really fatigued. Another member posted that she had trouble with exercise because it caused leg cramps. I feel so overwhelmed now. I really wanted to try it out I believe it could help me but I don't want to put my life at risk to try it. I looked up lactic acidosis and I was reading about the bloods ph and acid in your blood. I have a problem with uric acid in my blood but I believe that is not related to lactic acidosis. I have had a problem with kidney infections and a lot of crystals in my urine and kidney stones the past year, but I believe my kidney function is ok. Does metformin cause lactic acidosis very often? Are the symptoms of lactic acidosis easy enough to pick up on so it can be caught early. I am sorry I am such a worry wart. Thank you in advance for any guidance/reassurance from you.

  2. furball64801

    All I can tell you is that millions upon millions take met with 0 issues. You are reading the absolute worst side affects. Have you see tv commericails on meds that is any meds. They say could cause heart attack, fatigue, even death no kidding. I been on met and so has my diabetic family and 0 issues other than a tad of diahrea. To me its extemely rare many here are on met me a very very long time on it. What am I saying to me its about the best D med out there other than exercise its free. It is just my opion for what its worth, I know others might have other ideas and of course its is there opinion also. Some take b-12 if they get fatigued on met, I do not get that way, all I can say is to me its as safe as can be.

  3. coravh

    Every drug has potential side effects. Some more common than others. I'm not sure of the exact specifics, but I believe that for a side effect to be listed, it needs to happen in 1% of the people that take it.
    My husband has been on met with no side effects other than a little bit of tummy trouble. I have a dozen local diabetic friends (through volunteer work) that are also on it, and have no side effects. I do have one friend who reacts to everything and has no issues with it. I think i've only seen people with this issue a couple of times after about 15 years online haunting a variety of message boards.
    Take for example my warfarin. It can cause bleeding. Even a baby aspirin can cause this. And it does happen to some people. But the vast majority of folks don't have issues.
    Do you have some history of lactic acidosis? Or is this simply general anxiety over something new?
    All meds are a cost benefit analysis. Do you want to try the drug to alleviate a serious issue ( like high blood sugar) or do you decide to refuse it on the basis of a rare side effect and maybe get into trouble due to glucose issues? Why not try it? Discuss with your phamacist what to look for if you are worried. But basically it is a safe, effective drug.
    Cora

  4. -> Continue reading
read more
Share on facebook

Pain in Left Side | Learn How to treat Abdominal Pain in Left Side, Here are the common causes of abdominal pain and treatment and prevention solutions that you may use to live a healthy life. Check the new video here http://www.youtube.com/watch?v=fB8o-v... For more info on Stomach Pain in Left Side Check http://hlpain.com/963/abdominal-pain-...

Metformin-induced Lactic Acidosis: No One Left Behind

Abstract Metformin is a safe drug when correctly used in properly selected patients. In real life, however, associated lactic acidosis has been repeatedly, although rarely, reported. The term metformin-induced lactic acidosis refers to cases that cannot be explained by any major risk factor other than drug accumulation, usually due to renal failure. Treatment consists of vital function support and drug removal, mainly achieved by renal replacement therapy. Despite dramatic clinical presentation, the prognosis of metformin-induced lactic acidosis is usually surprisingly good. In the previous issue of Critical Care, Friesecke and colleagues demonstrate that the survival rate of patients with severe lactic acidosis due to metformin accumulation can be strikingly higher than expected based on the initial clinical evaluation [1]. Metformin is nowadays the first-line drug of choice for the treatment of adults with type 2 diabetes [2]. This drug is the sixth most frequently prescribed in the USA (> 50 million prescriptions in 2009) and is taken by almost 1.5% of the Italian population [3, 4]. Metformin is a safe drug when correctly used in properly selected patients. In particular, no cas Continue reading >>

Share on facebook

Popular Questions

  1. MAYS

    Metformin Induced Lactic Acidosis! ... It can happen to anyone!

    How many questions do you ask your doctor, pharmacist or medical team concerning your nedications?
    How much in the way of research do you do on your own pertaining to medications and treatment that has been prescribed, or administered unto you?
    Let's talk about the diabetes medication, "Metformin" and a serious complication that it can cause called " Lactic Acidosis" in some people.
    What is Metformin induced Lactic Acidosis?
    http://diabetes.emedtv.com/metformin/metformi...
    Diabetic Connect family member "granniesophie" sent me this message, which I am sharing with everyone here (with her permission) concerning "Metformin and Lactic Acidosis" from a very personal perspective, her very own words!
    " I have to sit on my hands everytime a Metformin discussion comes up! I have just been diagnosed, after 4 months of tests and pain and losing 20 pounds for no reason and 2 different doctors not having a clue until just a few days ago, with Lactic Acidosis, caused by Metformin. This is a very rare side effect wihich only affects 5% of users. I'd been on it for over 6 years now, and it just came up in June. It can be fatal if not caught in time. It has also done damage to my kidneys, which the doctors hope can be reversed.
    The FDA says this is not a side effect, and studies are out on it, but there is a black box warning on it that it can cause Lactic Acidosis in some people. I have to report it to the FDA.
    This is a dangerous drug, and I may never be 100 percent-
    I have just begun taking Lantus, since the doctor no longer wants me on any oral meds until we can assess the damage that the Met may have caused long term.
    I am one sick human and I have other meds that have been causing issues now as well, related or not. So I am being juggled on all my meds in hopes that there is no long term damage.
    Whether this gets mentioned in discussions or not (and I am not going to) people should be aware that the Gold Standard of Diabetes treatment has some darn nasty thorns."
    Sonya
    ——————————
    If you have any questions, or concerns about Metformin and Lactic Acidosis talk to your doctor or pharmacist, if you have any questions that you would like to ask "Sonya" personally concerning this you can contact her here:
    http://www.diabeticconnect.com/users/85827-gr...

  2. Mamawiggles

    Metformin can aggravate breathing. Stupid D.O. Put my dad on it! Endocrinologist took him off immediately. You see. He has copd. Put him on Lantus.

  3. Jimbo6217

    I've only been taking the drug for a week but I've already developed hives head to toe and painfully swelled hands and feet. The only kidney proems I've had are stones .

  4. -> Continue reading
read more
Share on facebook

Part 2: Defending metformin (from the haters) http://youtu.be/oH_6yW_YKLA Please watch my Glycemic index video as a supplement to this http://youtu.be/wGBqEojeEDE Metformin is often times the first diabetic drug I use in new diabetics. It is inexpensive, can be used with many other diabetic drugs in combination, it can cause weight loss and has been shown to decrease cardiovascular risk and even pancreatic cancer. It can be used safely in non-diabetics, and pre-diabetics. It can cause GI side effects, so when I start someone on it, I usually give them 1000mg pills, and the goal is to take 1000mg twice a day. Start with 1/2 pill once a day at dinner, in one week, Take 1/2 pill twice a day with food, in another week, take 1/2 pill in the morning and one at dinner, Finally advance to 1 pill twice a day. Some people cannot tolerate the full dose, and have to take somewhat less of a dose. Switching to the ER version can be helpful. If you eat lots of carbs, you will have more side effects. Limiting carbs, helps to tolerate it better AND can help you to lose more weight.

Metformin Associated Lactic Acidosis

Emma Fitzgerald, specialist trainee year 2 in anaesthetics 1 , Stephen Mathieu, specialist registrar in anaesthetics and intensive care medicine 1 , Andrew Ball, consultant in anaesthesia and intensive care medicine 1 1Dorset County Hospital, Dorchester, Dorset DT1 2JY Correspondence to: E Fitzgerald zcharm6{at}hotmail.com Dehydration in patients taking metformin can lead to metformin associated lactic acidosis, a potentially fatal condition 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 fi Continue reading >>

Share on facebook

Popular Questions

  1. MAYS

    Metformin Induced Lactic Acidosis! ... It can happen to anyone!

    How many questions do you ask your doctor, pharmacist or medical team concerning your nedications?
    How much in the way of research do you do on your own pertaining to medications and treatment that has been prescribed, or administered unto you?
    Let's talk about the diabetes medication, "Metformin" and a serious complication that it can cause called " Lactic Acidosis" in some people.
    What is Metformin induced Lactic Acidosis?
    http://diabetes.emedtv.com/metformin/metformi...
    Diabetic Connect family member "granniesophie" sent me this message, which I am sharing with everyone here (with her permission) concerning "Metformin and Lactic Acidosis" from a very personal perspective, her very own words!
    " I have to sit on my hands everytime a Metformin discussion comes up! I have just been diagnosed, after 4 months of tests and pain and losing 20 pounds for no reason and 2 different doctors not having a clue until just a few days ago, with Lactic Acidosis, caused by Metformin. This is a very rare side effect wihich only affects 5% of users. I'd been on it for over 6 years now, and it just came up in June. It can be fatal if not caught in time. It has also done damage to my kidneys, which the doctors hope can be reversed.
    The FDA says this is not a side effect, and studies are out on it, but there is a black box warning on it that it can cause Lactic Acidosis in some people. I have to report it to the FDA.
    This is a dangerous drug, and I may never be 100 percent-
    I have just begun taking Lantus, since the doctor no longer wants me on any oral meds until we can assess the damage that the Met may have caused long term.
    I am one sick human and I have other meds that have been causing issues now as well, related or not. So I am being juggled on all my meds in hopes that there is no long term damage.
    Whether this gets mentioned in discussions or not (and I am not going to) people should be aware that the Gold Standard of Diabetes treatment has some darn nasty thorns."
    Sonya
    ——————————
    If you have any questions, or concerns about Metformin and Lactic Acidosis talk to your doctor or pharmacist, if you have any questions that you would like to ask "Sonya" personally concerning this you can contact her here:
    http://www.diabeticconnect.com/users/85827-gr...

  2. Mamawiggles

    Metformin can aggravate breathing. Stupid D.O. Put my dad on it! Endocrinologist took him off immediately. You see. He has copd. Put him on Lantus.

  3. Jimbo6217

    I've only been taking the drug for a week but I've already developed hives head to toe and painfully swelled hands and feet. The only kidney proems I've had are stones .

  4. -> Continue reading
read more

No more pages to load

Related Articles

  • Lactic Acidosis Metformin Symptoms

    Abstract Metformin is a safe drug when correctly used in properly selected patients. In real life, however, associated lactic acidosis has been repeatedly, although rarely, reported. The term metformin-induced lactic acidosis refers to cases that cannot be explained by any major risk factor other than drug accumulation, usually due to renal failure. Treatment consists of vital function support and drug removal, mainly achieved by renal replacemen ...

    diabetes May 1, 2018
  • Why Does Metformin Cause Lactic Acidosis?

    Lactic acidosis refers to the build up of the acid 'lactate' (also known as lactic acid) in the blood. We all produce lactic acid when breaking down sugar at times of stress and when we exercise vigorously. In some circumstances, too much lactic acid can build up in the blood. This happens particularly in situations where there is not enough oxygen in the blood, or the kidneys are not filtering out lactic acid as they should be. Examples of these ...

    ketosis May 1, 2018
  • How To Prevent Lactic Acidosis

    Reader Approved Three Parts:Understanding Lactic AcidReducing Lactic Acid During a WorkoutReducing Lactic Acid Through Your DietCommunity Q&A Lactic acid is released into the muscles when they have used up their normal energy stores but still have intense energy needs. Small amounts of lactic acid operate as a temporary energy source, thus helping you avoid fatigue during a workout. However, a buildup of lactic acid during a workout can create bu ...

    ketosis Jan 23, 2019
  • What Are The Signs Of Lactic Acidosis With Metformin?

    Actos (pioglitazone) is an oral Type 2 diabetes drug that lowers blood sugar by decreasing insulin resistance and reducing the amount of glucose made in the liver. This allows the body to better dispose of excess blood sugar. Typically, the dose starts at 15 or 30 mg and is taken once a day, but some people may require a stronger dose. Doctors can increase the strength of the medicine by 15 mg increments to a maximum of 45 mg daily. However, nume ...

    ketosis Apr 24, 2018
  • How Metformin Cause Lactic Acidosis

    Metformin is a prescription drug used to treat type 2 diabetes. It belongs to a class of medications called biguanides. People with type 2 diabetes have blood sugar (glucose) levels that rise higher than normal. Metformin doesn’t cure diabetes. Instead, it helps lower your blood sugar levels to a safe range. Metformin needs to be taken long-term. This may make you wonder what side effects it can cause. Metformin can cause mild and serious side ...

    ketosis Apr 30, 2018
  • How To Prevent Lactic Acidosis When Taking Metformin

    Metformin-induced lactic acidosis: no one left behind 1Centro Nazionale di Informazione Tossicologica - Centro Antiveleni, IRCCS Fondazione Salvatore Maugeri, Via S. Maugeri 10, 27100 Pavia, Italy 2Dipartimento di Anestesiologia, Terapia Intensiva e Scienze Dermatologiche, Universit degli Studi di Milano, Via F.sco Sforza 35, 20122 Milano, Italy This article has been cited by other articles in PMC. Metformin is a safe drug when correctly used in ...

    ketosis Jan 23, 2019

More in ketosis