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While rare, lactic acidosis (when lactic acid, the same thing that makes you sore after a workout, builds up in the blood) can be a side effect in those with poor kidney or liver function or due ...
Metformin: this risk is low (less than 10 cases for 100,000 patient years), but the risk of metformin-induced lactic acidosis (MALA) increases in certain situations where both the plasma levels of metformin are increased and lactate clearance is impaired. [8]
Metformin is more commonly associated with gastrointestinal adverse effects than most other antidiabetic medications. [46] [77] The most serious potential adverse effect of metformin is lactic acidosis; this complication is rare, and seems to be related to impaired liver or kidney function.
The drug metformin can cause lactic acidosis in patients with kidney failure because metformin inhibits the hepatic gluconeogenesis of the Cori cycle, particularly the mitochondrial respiratory chain complex 1. [8] The buildup of lactate and its substrates for lactate production, pyruvate and alanine, lead to excess lactate. [9]
Symptoms of lactic acidosis include nausea, vomiting, and weakness. If you experience serious side effects when taking metformin, seek medical advice immediately.
Typical reduction in glycated hemoglobin (A1C) values for Metformin is 1.5–2.0% Metformin (Glucophage) may be the best choice for patients who also have heart failure, [10] but it should be temporarily discontinued before any radiographic procedure involving intravenous iodinated contrast, as patients are at an increased risk of lactic acidosis.
High anion gap metabolic acidosis is a form of metabolic acidosis characterized by a high anion gap (a medical value based on the concentrations of ions in a patient's serum). Metabolic acidosis occurs when the body produces too much acid , or when the kidneys are not removing enough acid from the body.
Acute complications are complications that develop rapidly and can be exemplified as diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), lactic acidosis (LA), and hypoglycemia. [1] Chronic complications develop over time and are generally classified in two categories: microvascular and macrovascular .