ReviewJournal of nephrology
Metformin-associated lactic acidosis: case reports and literature review.
Review in Journal of nephrology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT02491333. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Acupuncture on Insulin Sensitivity of Women With Polycystic Ovary Syndrome and Insulin Resistance: a Randomized Controlled Trial
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 111 citations in OpenAlex.
- Effectiveness of medications used to attenuate antipsychotic-related weight gain and metabolic abnormalities: a systematic review and meta-analysis.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2010Pooled it
- Effect of acupuncture and metformin on insulin sensitivity in women with polycystic ovary syndrome and insulin resistance: a three-armed randomized controlled trial.Human reproduction (Oxford, England) · 2022Trial
- Trial
- Diagnosing Metformin Intoxication with High-Resolution Platelet Respirometry: A Case Report.International journal of molecular sciences · 2026Article
- Article
- Where Is the Lactate Coming From? An Unusual Presentation of Persistent Lactic Acidosis.Cureus · 2026Article
- Patterns and characteristics of polypharmacy among elderly residents in Danish nursing homes.Future science OA · 2020Article
- Fatal metformin overdose presenting with refractory hypotension: Postmortem examination.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2020Article
- Article
- Extracorporeal treatment with high-volume continuous venovenous hemodiafiltration and charcoal-based sorbent hemoperfusion for severe metformin-associated lactic acidosis.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2016Article
- Metformin and metabolic diseases: a focus on hepatic aspects.Frontiers of medicine · 2015Review
- Diabetes mellitus and suicide.Indian journal of endocrinology and metabolism · 2014Review
- Update on Safety Issues Related to Antihyperglycemic Therapy.Diabetes spectrum : a publication of the American Diabetes Association · 2014Article
- Metformin in Diabetic Patients with Heart Failure: Safe and Effective?Current cardiovascular risk reports · 2013Article
- Metformin-related lactic acidosis in patients with acute kidney injury.International urology and nephrology · 2011Article
- Dynamic lactate indices as predictors of outcome in critically ill patients.Critical care (London, England) · 2011Article
- Acute rhabdomyolysis during treatment with amisulpride and metformin.European journal of clinical pharmacology · 2010Article
- Mimetics of hormetic agents: stress-resistance triggers.Dose-response : a publication of International Hormesis Society · 2010Article
- Relative hyperlactatemia and hospital mortality in critically ill patients: a retrospective multi-centre study.Critical care (London, England) · 2010Article
- Outcome of severe lactic acidosis associated with metformin accumulation.Critical care (London, England) · 2010Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLactic acidosis is a widely recognized, though rare, side effect of metformin. This paper describes five patients admitted to Chang Gung Memorial Hospital from 1 September 1998 to 31 May 2001 suffering severe lactic acidosis caused by metformin, and reviews the literature. PATIENTS: Five cases diagnosed as having meftormin-associated lactic acidosis (MALA) were discovered during the study period. Three had normal renal function before the onset of MALA and two had attempted suicide bytaking large amounts of metformin. One patient with end-stage renal disease developed MALA despite regularhemodialysis three times a week. One of the patients who had taken metformin to attempt suicide was not diabetic.
resultsAll patients suffered severe metabolic acidosis with a high anion gap and blood lactate level. Four developed profound hypotension, and three of these also suffered acute respiratory failure. Three patients received conventional hemodialysis and two continuous renal replacement therapy. A young non-diabetic female who had taken a large dose of metformin to commit suicide died from multiple organ failure despite aggressive treatment.
conclusionsLactic acidosis is a serious reaction to metformin, and hemodialysis (the treatment of choice) should be done urgently to prevent serious complications. MALA should be suspected in patients presenting with wide anion gap metabolic acidosis and high blood lactate, even when they are non-diabetic.
Indexed as
Identifiers
12243370W2242296801What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.