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Metformin Overdose Fatal

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Metformin Overdosage

Metformin is a biguanide used to treat type 2 diabetes mellitus and most commonly prescribed oral hypoglycemic agent. Metformin is now also used to treat polycystic ovary syndrome and some malignancies. Despite a good safety profile in a majority of patients with diabetes, the risk of metformin-associated lactic acidosis is genuine when safety guidelines are ignored. Overdoses with metformin are rare, but may result in serious consequences. Case reports and small case series of serious toxicity from metformin overdosage can be found in the medical literature, often with the portrayal of extracorporeal methods for the management of the subsequent severe lactic acidosis. Lactic acidosis can defined as a metabolic acidosis with a blood pH less than 7.35 and a serum lactate more than 2 mmol per liter. It can occur either with therapeutic metformin dosing (which is rare) or in overdose situations. 0.03 cases of lactic acidosis per 1000 patient-years occur within therapeutic dosing, with a majority of these cases among patients that have contraindications to metformin (such as renal insufficiency). In overdose situations, lactic acidosis is seen much more habitually, even though the prec Continue reading >>

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Popular Questions

  1. Saraleesaralee

    Is it possible to stay on ketogenic diet for life-long?

    I have been on ketogenic diet for 2 weeks. It controls my blood sugar level really well. However I am not over weight. And I am worried about potential long term side effects of the diet. For example, high LDL level, steoporosis, auto immune disease, too much weight loss, vesicular stiffness. I was wondering if there is anyone in this forum has been on ketogenic diet for years? And do you experience any side effects from the diet?

  2. Aaron1963

    I've been on a strict ketogenic diet for 6 months, and was doing LCHF for much of the 5 months prior to that but didn't make any attempts at it being ketogenic so I may have been in and out of ketosis some during that period. I now have a blood ketone meter and remain in ketosis according to it.
    I did suffer excessive weight loss initially. I lost about 40kg (about 90 lbs.), and it ended up sending me from being very obese to being underweight. But I've always eaten very little protein, which I continued to do, plus I was doing intermittent fasting, sometimes not eating anything for days at a time. Once I stopped the intermittent fasting and concentrated on getting adequate protein, my weight went back up to my ideal weight and stabilized there. I've heard from several people that you really need to watch your protein when doing a ketogenic diet being it's easy for excess to hinder weight loss and/or increase your BG.
    I have had a few issues while doing a ketogenic diet, but not 100% sure which if any can be attributed to ketosis vs. some other factor. First off, as winter was approaching I got extremely cold all the time, especially my fingers and toes, but even my whole body was cold. I thought it might have been the caffeine I was getting as part of my ketogenic diet involves drinking lots of coffee with HWC, coconut oil, and butter. I switched to decaf and the problem pretty much went away, but I don't know if it was the caffeine, the ketosis, the massive weight loss (lack of body fat), something else, or a combination of factors.
    I've also had excessive itching and a rash. That's normal for me during the winter months, but this year it started a bit early, went longer, and was much worse than normal. I think it may very well have been my usual sensitivity to the cold dry weather, aggravated by toxins released during my rapid weight loss, and perhaps ketones being emitted through the skin. It's just recently started to clear up and the rash is gone and most of the itching.
    I got keto-breath for a week or two when I first concentrated on going keto. It was very noticeable, but disappeared after that and no issues anymore with my breath.
    This diet is very sustainable for me. I tried my whole adult life to diet to lose weight and was never successful. This time I wanted to lose weight, but my primary focus was controlling my BG, meaning reducing carbs down to a low-carb level, which caused me to gravitate naturally to a LCHF diet. For the first time I have no desire to go back to my old way of eating. I love this diet and it's completely satisfying. So I killed two birds with one stone - got my BG under control, down to non-diabetic levels, and got my weight down to ideal. Plus with the huge benefits (IMHO) of having my body use ketones rather than glucose, I'm totally sold on this way of eating for the rest of my life and have absolutely no worries about not being able to stick to my diet. I really have no strong urges for carbs anymore, and only end up going off the plan rarely due to social pressures or inadvertently eating hidden/unknown carbs.
    My LDL has gone up, but I've heard from others that usually it's benign large fluffy LDL that typically goes up when on a ketogenic diet. And my body is still adjusting. Also I've heard that LDL by itself is not a good measure of risk. So I'm not worried about it, but will keep an eye on things. I also have taken my ketogenic diet to an extreme, hitting a KR of 3.0 or higher almost everyday, and sometimes up to 4.0 or more. Not sure if eating much more fat than necessary for ketosis affected my LDL any or not. Initially my LDL dropped significantly as well as my trigs, but both increased at my last doctor's visit. I may try a more normal KR in the future while monitoring my blood ketones to verify I stay in ketosis and see if there's any difference in my BG, cholesterol, or other tests.
    I did also suffer from other typical symptoms during my keto adaptation phase. Most went away within about two weeks. But it's just been here at the 6-month mark where my BG numbers suddenly stabilized with very little change, and quite low, and overall I just feel absolutely fantastic. I feel like I'm bursting with energy and joined a gym and suddenly love running and working out whereas I hated them all my life.
    Well, I don't have years of experience with ketosis to report anything to you about that. Other than I've heard lots of other people with years of experience and not heard of anyone having any real side effects other than the things I've mentioned. However some people do find ketosis isn't for them and give up very soon. For those that feel it is working for them and stick with it, seems there's no significant side effects. But I'll let the others who've been in ketosis for longer than me speak for themselves.

  3. furball64801

    Hi and welcome to DD I know of a guy called no more carbs that was on it over 2 yrs. It is possible he is still on it, that chat site closed down but he was going strong on it.

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