Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes

Eun Young Lee; Hyun Chul Lee; 황세나; 이용호; Seo Hee Lee; 이영미; 강화평; 한의진; 이운형; Lee Byung-Wan; Kang Eun Seok; BongSoo Cha

Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes

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Type: Academic journal

Author: Eun Young Lee Hyun Chul Lee 황세나 이용호 Seo Hee Lee 이영미 강화평 한의진 이운형 Lee Byung-Wan Kang Eun Seok BongSoo Cha

Journal: Yonsei University College of Medicine Yonsei Medical Journal Yonsei Medical Journal 제58권 제2호 KCI Accredited Journals

Published: 2017.1

Pages: 312 - 318 (7page)

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Association between Metformin Use and Risk of Lactic Acidosis or Elevated Lactate Concentration in Type 2 Diabetes

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Purpose: Metformin can reduce diabetes-related complications and mortality. However, its use is limited because of potential lactic acidosis-associated adverse effects, particularly in renal impairment patients. We aimed to investigate the association of metformin use with lactic acidosis and hyperlactatemia in patients with type 2 diabetes. Materials and Methods: This was a cross-sectional study from a tertiary university-affiliated medical center. A total of 1954 type 2 diabetes patients were recruited in 2007–2011, and stratified according to the estimated glomerular filtration rate of 60 mL/min/1.73 m2. Lactic acidosis was defined as plasma lactate levels >5 mmol/L and arterial pH <7.35. Results: Metformin was used in 61.4% of the patients with type 2 diabetes mellitus. Plasma lactate levels were not different in the patients with and without metformin use. There was no difference in prevalence of hyperlactatemia and lactic acidosis between the patients with and without metformin use (18.9% vs. 18.7%, p=0.905 for hyperlactatemia and 2.8% vs. 3.3%, p=0.544 for lactic acidosis). Similar results were observed in the patients with estimated glomerular filtration rate <60 mL/min/1.73 m2. Most patientswith lactic acidosis had at least one condition related to hypoxia or poor tissue perfusion. Multiple regression analysis indicatedno association between metformin use and lactic acidosis, whereas tissue hypoxia was an independent risk factor for lactic acidosis [odds ratio 4.603 (95% confidence interval, 1.327–15.965)]. Conclusion: Metformin use was not associated with hyperlactatemia or lactic acidosis in patients with type 2 diabetes.

#Metformin #lactic acidosis #diabetes mellitus #lactate

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