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What Is Metformin Lactic Acidosis?

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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.

Metformin-associated Lactic Acidosis

Summarized from Friesecke S, Abel P, Roser M. Outcome of severe lactic acidosis associated with metformin accumulation. Critical Care 2010; 14: R226-210 Metformin is an oral hypoglycemic drug that has long been employed in the treatment of type 2 diabetes; it is particularly widely prescribed for those diabetics who are obese. Very rarely, metformin use results in severe lactic acidosis, most often occurring in patients with reduced renal function. Although a very rare adverse effect, metformin-associated lactic acidosis (MALA) is significant because it has a high (30-50 %) mortality rate. Lactic acidosis (unrelated to metformin) is a relatively common occurrence among the critically ill and usually arises as a result of tissue hypoxia consequent on the inadequate perfusion associated with clinical shock. The list of severe acute illnesses/conditions that can result in lactic acidosis is long and includes severe sepsis (septic shock), severe trauma (hemorrhagic shock), anaphylactic shock, cardiac arrest and acute liver failure. In all of these cases prognosis is predicted by the severity of the lactic acidosis; the higher the peak serum lactate and the lower the blood pH falls, th Continue reading >>

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  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

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https://www.facebook.com/drinkhealthy... - Do you want to learn how to get rid of lactic acid as an athlete, and start recovering quicker with more energy? Learn how to reduce lactic acid symptoms and increase your performance. Getting rid of lactic acid may be easier than you have imagined. Many professional athletes know the importance of eliminating lactic acid so they can recover quicker and perform at an optimal level. Start flushing out that lactic acid today! Many people suffer from lactic acidosis symptoms and are rigorously searching for a lactic acid treatment. More and more athletes are searching for solutions on how to get rid of lactic acid. In this video you will learn what a professional football player from the Seattle Seahawks is using to eliminate lactic acid after his workouts, practices, and NFL games. Learn how to make lactic acid a symptom of the past. Begin your journey to faster recovery today. See what the pro's are using to reduce lactic acid, recover quicker, and have more energy. Uncertain of what lactic is? Here is the definition https://en.wikipedia.org/wiki/Lactic_... Contact me for more information on getting rid of lactic acid FB: http://www.facebook.com/duncan.fraser... IG: http://www.instagram.com/kangendunc [email protected] See a full demonstration of this solution that helps get rid of lactic acid https://www.youtube.com/watch?v=MTxR9... Duncan Fraser 0:00 - 0:13 - Introduction 0:14 - 2:11 - Shan Stratton and Michael Robinson Discuss how to get rid of lactic acid 2:11 - 2:21 - 4 benefits of this incredible technology 2:21 - 2:39 - Conclusion Get in contact with me if you have problems with lactic acid and learn more on my FB page. Visit my Facebook page below. https://www.facebook.com/drinkhealthy...

Lactic Acidosis

The buildup of lactic acid in the bloodstream. This medical emergency most commonly results from oxygen deprivation in the body’s tissues, impaired liver function, respiratory failure, or cardiovascular disease. It can also be caused by a class of oral diabetes drugs called biguanides, which includes metformin (brand name Glucophage). Another biguanide called phenformin was pulled from the market in the United States in 1977 because of an unacceptably high rate of lactic acidosis associated with its use. Concerns about lactic acidosis also delayed the introduction of metformin to the U.S. market until 1995, despite the fact that it had been widely used for years in other countries. There have been reports of lactic acidosis occurring in people taking metformin, and the U.S. Food and Drug Administration estimates that lactic acidosis occurs in 5 out of every 100,000 people who use metformin for any length of time. However, this risk is much lower than it was in people taking phenformin, and it is not clear whether the episodes of lactic acidosis associated with metformin have actually been due to metformin use. In fact, the lactic acidosis could have been explained by the person Continue reading >>

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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
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Metformin, Diabetes Mellitus, Adverse effects of metformin, How does metformin work, Mechanism of action of metformin, Indications of metformin, Contraindications of metformin, Blood Glucose, Hypoglycemia, Side Effects of metformin Adverse effects of metformin, Oral hypoglycemic Drugs, Metformin and lactic Acidosis, Type II diabetes mellitus, NIDDM, Non insulin dependent diabetes mellitus, Uses of Metformin. About Me: Dr. Sumit Verma MD, DNB , with more than 15 years of experience in clinical medicine / clinical research / pharmacovigilance domain I have co-authored a book titled "Fundamentals of Pharmacovigilance" (http://www.amazon.in/Fundamentals-Pha...) https://www.linkedin.com/in/dr-sumit-... Disclaimer: Medicine is an ever-changing science. The information presented in the video or on this channel is of a general informational nature and should not be considered as specific to the needs of a particular individual or organisation or entity. Please consult your doctor, medical specialist or your health care professional for all matters related to health. The video does not contain all the information about any drug. Any information presented in the video or on this channel does not replace any advice given to you by your doctor, medical specialist or your health care professional. If you have any queries or concerns regarding the information presented in the video or on this channel, please consult your doctor, specialist, your health care professional or seek professional advise. Any use of information presented herein (including content of the videos or on this channel) is at the user's own risk. The author, presenter or any other parties associated with the content of the videos or on this channel do not assume and hereby disclaim any liability (including, without limitation, damages for loss of data or profit, or due to business interruption) to any party for any loss, damage, or disruption that may directly or indirectly result from use of any information or graphics in the videos or on this channel. The author, presenter or any other parties associated with the content (presented in the videos or on this channel) will not be held liable for any errors or omissions that may be found in the content of the videos or on this channel. Any information presented in the video or on this channel is provided 'as is'. The author, presenter or any other parties associated with the content of the videos or on this channel, make no warranties, expressed or implied, and hereby disclaim and negate all other warranties, including without limitation, implied warranties or conditions of merchantability, fitness for a particular purpose, or non-infringement of intellectual property or other violation of rights. Further, the author, presenter or any other parties associated with the content of the videos or on this channel do not warrant or make any representations concerning the accuracy, likely results, or reliability of the use of the materials on the video or on this channel. The materials appearing on the video or on this channel may include technical, typographical, or photographic errors. The author, presenter or any other parties associated with the content of the videos or on this channel do not warrant that any of the materials presented herein are accurate, complete, or current. No one should act on any information presented in the videos or on this channel without specific professional advise.

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 >>

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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

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