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- Title
Metformin-induced lactic acidosis: A review.
- Authors
Vijay, V. P. Derbin; Praveen, D.; Chowdary, P. Ranadheer; Aanandhi, M. Vijey
- Abstract
Metformin is an oral anti-diabetic drug that is widely used alone or in combination with other drugs with type 2 diabetes mellitus. Metformin increases insulin sensitivity, enhances peripheral glucose utilization and decreases glucose uptake in the gastrointestinal tract. Lactic acidosis is characterized by the buildup of lactate (especially L-lactate) in the body, which results in an excessively low pH in the bloodstream. Lactic acidosis is about 20 times less frequent with metformin than phenformin. Lactate is produced by the gut, liver, and peripheral tissues during glycolysis and can accumulate during hypoxic conditions. Lactate can either be oxidized to carbon dioxide and water by mitochondria to generate energy or converted back to glucose (gluconeogenesis) in the liver and kidney. When metformin is administered orally, approximately 40% of the dose is absorbed. Metformin-associated lactic acidosis is more likely to occur in patients who acutely develop renal impairment from dehydration, vomiting or diarrhea, surgery, etc., especially in elderly subjects who have a reduced glomerular filtration rate.
- Subjects
TYPE 2 diabetes treatment; METFORMIN; LACTIC acidosis; PH effect; CLINICAL trials
- Publication
Drug Invention Today, 2018, Vol 10, Issue 2, p216
- ISSN
0975-7619
- Publication type
Article