Lactic Acidosis Causes

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Review Metformin-associated Lactic Acidosis: Current Perspectives On Causes And Risk

Abstract Although metformin has become a drug of choice for the treatment of type 2 diabetes mellitus, some patients may not receive it owing to the risk of lactic acidosis. Metformin, along with other drugs in the biguanide class, increases plasma lactate levels in a plasma concentration-dependent manner by inhibiting mitochondrial respiration predominantly in the liver. Elevated plasma metformin concentrations (as occur in individuals with renal impairment) and a secondary event or condition that further disrupts lactate production or clearance (e.g., cirrhosis, sepsis, or hypoperfusion), are typically necessary to cause metformin-associated lactic acidosis (MALA). As these secondary events may be unpredictable and the mortality rate for MALA approaches 50%, metformin has been contraindicated in moderate and severe renal impairment since its FDA approval in patients with normal renal function or mild renal insufficiency to minimize the potential for toxic metformin levels and MALA. However, the reported incidence of lactic acidosis in clinical practice has proved to be very low (< 10 cases per 100,000 patient-years). Several groups have suggested that current renal function cutof Continue reading >>

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Popular Questions

  1. swt_tease

    My very sweet, supportive DH broke the news to me today that my breath stinks since going on this liquid diet.
    Is this a common thing?
    I didn't have bad breath before.
    ::: Help ::: (Keeping my mouth covered with my hand!)

  2. Andie

    I didn't do the "liquid diet" except post op....and yes my breath STANK!!! It has something to do with Ketosis...and your body burning the fat and expelling it through your mouth. Wish I could help ya...I bought stock in sugar free mints and sucked on em like crazy and brushed my teeth and used mouth wash any time I went potty. Hang in there...things will get back to normal eventually!!

  3. katzz87

    I didn't have a pre-op diet...but let me tell you post-op I could have taken paint off of the walls! It tastes sickly sweet and stinky at the same time...KETOSIS! But it tells you that you're losing weight...and it gets better, I promise!
    The first month is bad, then it slowly fades after time (unless we just get used to it and I'm still having stinky breath and don't know it...)

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