diabetestalk.net

Metformin Raised Lactate

Share on facebook

Lactic Acidosis Secondary To Metformin Overdose: A Case Report

Timbrell et al.; licensee BioMed Central Ltd.2012 Metformin is a commonly used treatment modality in type 2 diabetes mellitus, with a well documented side effect of lactic acidosis. In the intensive care setting lactate and pH levels are regularly used as a useful predictor of poor prognosis. In this article we highlight how high lactate levels are not an accurate predictor of mortality in deliberate metformin overdose. We present the case of a 70-year-old Caucasian man who took a deliberate metformin overdose of unknown quantity. He had a profound lactic acidosis at presentation with a pH of 6.93 and a lactate level of more than 20mmol/L. These figures would normally correspond with a mortality of more than 80%; however, with appropriate management this patients condition improved. We provide evidence that the decision to treat severe lactic acidosis in deliberate metformin overdose should not be based on arterial lactate and pH levels, as would be the case in other overdoses. We also demonstrate that appropriate treatment with hemodiafiltration and 8.4% sodium bicarbonate, even in patients with a very high lactate and low pH, can be successful. MetforminLactate LevelLactic Acido Continue reading >>

Share on facebook

Popular Questions

  1. BobbyS

    Can insulin resistance truly be reversed?

    I'm a bit unclear on what "insulin resistance reversal" or "diabetes reversal" really means.
    I was diagnosed as prediabetic about 3 weeks ago. I got a blood meter and my first test was postprandial and showed 191.
    I have been water fasting and eating LCHF since then...except for 3 days which is where I get the following info:
    It appears that "real food carbs" (e.g. carrots, onions, etc.) have virtually no effect on me. A meal with ~ 80 grams of real food carbs moved my blood glucose from 83 to 89.
    It also appears that eating LCHF keeps my blood glucose well < 100 but a single sugar/starch/refined flour meal will spike my blood sugar anywhere from 150 to 160 (I've eaten 2 such meals is where I get this data) and it takes a couple of days for my blood sugar to drop back below 100 (at least at my "dawn phenomenon" readings).
    Is "insulin resistance reversal" truly possible or can insulin resistance only be managed as long as sugar/starch/refined is avoided like the plague?
    I know I can't go back to eating like I used to eat...but it would be nice to hope that one day I will be able to "splurge occasionally" and keep normal blood sugar numbers...

  2. qsefthuko

    You might. Some people can some people can't.

  3. qsefthuko

    Apparently LCHF causes a degree of insulin resistance or something. If you have been eating LCHF for a bit and then eat a carby meal it can and probably will raise you higher than you might expect.

  4. -> Continue reading
read more
Share on facebook

Risk Of Lactic Acidosis Or Elevated Lactate Concentrations In Metformin Users With Renal Impairment: A Population-based Cohort Study.

Risk of lactic acidosis or elevated lactate concentrations in metformin users with renal impairment: a population-based cohort study. Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Center, Nijmegen, the NetherlandsHospital Pharmacy 'ZANOB', 's-Hertogenbosch, the Netherlands. Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht, the NetherlandsDepartment of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, the Netherlands. Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht, the Netherlands. Hospital Pharmacy 'ZANOB', 's-Hertogenbosch, the NetherlandsDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht, the Netherlands. Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands. Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Center, Nijmegen, the NetherlandsDepartment of Clinical Pharmacy, Radboud University Nijmegen Medical Center, Nijmegen, the Netherla Continue reading >>

Share on facebook

Popular Questions

  1. oxmoore

    How can I stop the diarrhea caused by metformin?

    I was just diagnosed with diabetes. Last week my doctor prescribed metformin to me. I take one 500mg pill two times a day. I have been having diarrhea about 2 hours after each dose. Is this normal and will it go away? I, also, take lisinopril for blood pressure and a baby aspirin for heart protection.

  2. SU suzanne66

    The most common side-effects of Metformin are feeling sick, diarrhea and abdominal pain. These symptoms do not usually last long.
    If the side effects do not settle or become bothersome talk with your doctor.
    Your dose may need to be reduced to allow your body to adjust.
    Your doctor may consider switching you to an slow-release medication which may reduce diarrhea, because smaller amounts are absorbed over the day rather than hitting your system all at once.
    Make sure you take metformin just after a meal or with a snack.

  3. SH

    I take slow release metformin and I still suffer from dreadful diarrhea. I am getting very depressed about this it is making me feel ill.

  4. -> Continue reading
read more
Share on facebook

Metformin Associated Lactic Acidosis

Emma Fitzgerald, specialist trainee year 2 in anaesthetics 1, Stephen Mathieu, specialist registrar in anaesthetics and intensive care medicine1, Andrew Ball, consultant in anaesthesia and intensive care medicine1 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 first l Continue reading >>

Share on facebook

Popular Questions

  1. cantrememberzombie

    I had just started keto and found out that same week that I'm pregnant (guess that's why I wasn't losing weight before). I'm seriously unhappy with how big I am at this point, 170, and I tend to gain a lot during pregnancy. I'm only 5'0 so every pound SHOWS. So, my question is in the title, is it safe to drop weight, say maybe 30lbs or so, during pregnancy or would it hurt the baby?

  2. fwargh

    Neither female nor a doctor, but I've seen it said more than once on here that it's fine as long as you're not actually starving yourself (getting the nutrients you need plus enough protein & calories to prevent muscle loss). Recommend you x-post this to /r/xxketo, also, might get you some better answers, and feel free to do some searching on /r/ketoscience and Google and see if there's any studies on ketosis+pregnancy one way or the other.
    Hope this helps!

  3. saraoflaherty

    http://www.reddit.com/r/KetoBabies
    I stayed very low carb my last pregnancy(until food cravings killed me in 3rd tri) and plan to do the same for my next one, hopefully more successfully.
    This post has some really great explanations on the whole thing. http://www.reddit.com/r/KetoBabies/comments/233xky/the_importance_of_glucose_for_developing_fetus/

  4. -> Continue reading
read more

No more pages to load

Related Articles

  • D Lactate Acidosis Symptoms

    AddthisShare | Facebook Twitter Pinterest Gmail var addthis_exclude = 'print, email'; D-Lactic Acidosis Craig Petersen RD, CNSC D-lactic acidosis, also referred to as D-lactate encephalopathy, is a rare neurological syndrome that can occur in individuals with short bowel syndrome (SBS) or following jejuno-ileal bypass surgery. A home parenteral or enteral nutrition (HPEN) consumer may develop the neurological symptoms—which can be quite strikin ...

    ketosis Apr 27, 2018
  • Metformin Raised Lactate

    Extreme lactic acidosis type B associated with metformin treatment Department of Anaesthesiology, Skne University Hospital, Lund University, Malm, Sweden Search for other works by this author on: Department of Intensive Care Medicine, Skne University Hospital, Lund University, Malm, Sweden Search for other works by this author on: Department of Endocrinology, Skne University Hospital, Lund University, Malm, Sweden Search for other works by this ...

    ketosis Apr 3, 2018
  • Can Ringer Lactate Cause Lactic Acidosis?

    L-lactate and D-lactate - clinical significance of the difference L-lactate and D-lactate - clinical significance of the difference Modern blood gas analyzers often have incorporated sensor technology that allows measurement of plasma lactate concentration. In nature lactate exists in two isoforms: L-lactate and D-lactate. In all vertebrates, including humans, the L-lactate form is by far the most abundant and pathophysiologically significant, a ...

    ketosis Apr 25, 2018
  • Outline Why A Carbohydrate Controlled Diet Is Important In Preventing Raised Blood Glucose Levels

    Hyperglycaemia is the medical term for a high blood sugar (glucose) level. It's a common problem for people with diabetes. It can affect people with type 1 diabetes and type 2 diabetes, as well as pregnant women with gestational diabetes. It can occasionally affect people who don't have diabetes, but usually only people who are seriously ill, such as those who have recently had a stroke or heart attack, or have a severe infection. Hyperglycaemia ...

    diabetic diet Apr 24, 2018
  • D Lactate Acidosis Treatment

    D-lactic acidosis a very rare form of metabolic acidosis explained Summarized from Kowgli N, Chhabra L. D-lactic acidosis: an underrecognized complication of short bowel syndrome. Gastroenterology Research and Practice 2015. Available on line at: Health demands that the pH of blood is maintained within a narrow range (7.35-7.45). Monitoring this physiological imperative and detection of so-called acid-base disturbance, in which blood pH is eithe ...

    ketosis Apr 5, 2018
  • How Is Blood Sugar Raised

    Regular physical activity and exercise are recommended for the general population for overall improved health. However, exercise of moderate intensity increases the risk of hypoglycemia during and following exertion in those with type 1 diabetes mellitus (T1DM). Accordingly, exercise guidelines for T1DM focus on prevention of exercise-induced hypoglycemia. The risk of hypoglycemia may discourage some with T1DM from exercising. Children and youth ...

    blood sugar Jan 18, 2018

Popular Articles

More in ketosis