Incidence Of Metformin Induced Lactic Acidosis

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Lactic Acidosis And The Relationship With Metformin Usage: Case Reports

Lactic acidosis (LA) is defined as a state of decreased systemic pH (pH <7.35) and an elevated plasma lactate concentration (>5 mmol/L). It remains the most common cause of metabolic acidosis in hospitalized patients. [1] A recent review summarized the major causes of LA and the presumed mechanisms. [2] Typically, LA is divided into disorders associated with tissue hypoxia (Cohen and Woods classification type A) and disorders in which tissue hypoxia is absent (type B). Type A LA may result from severe heart failure, sepsis, or cardiopulmonary arrest; type B can be caused by renal and hepatic failure, diabetes mellitus (DM), or drugs and toxins, including metformin, valproate, and anti-retroviral agents. [3,4] It has been reported that cardiogenic or hypovolaemic shock, severe heart failure, trauma, and sepsis are the most common causes of LA. [5] Lactate accumulation may be caused by increased production (i.e., increase glycolysis caused by hypoperfusion, hypoxaemia), decreased clearance (impaired hepatic metabolism or renal excretion), or a combination of both. [6] The exact pathophysiology of elevated lactate is likely to be the result of more than 1 condition. Many studies have Continue reading >>

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Popular Questions

  1. RedhairedNurse

    Your nursing text should point out the difference. I would tell you, but I'd just have to look it up and my books are in storage. I could also google it, but something you can also do as well. Sorry.

  2. RedhairedNurse


  3. Ilithya

    In HHNS, blood sugar levels rise, and your body tries to get rid of the excess sugar by passing it into your urine, your body tries to compensate. This usually happens to type 2s
    In DKA there is little to no circulating insulin. DKA occurs mainly, but not exclusively, in Type 1 diabetes because Type 1 diabetes is characterized by a lack of insulin production in the pancreas. It is much less common in Type 2 diabetes because the latter is closely related to cell insensitivity to insulin, not -- at least initially -- to a shortage or absence of insulin. Some Type 2 diabetics have lost their own insulin production and must take external insulin; they have some susceptibility to DKA. You get acidosis in DKA because ketones lower the bloods pH.
    Does that help?

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