Metformin
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Lactic acidosis in an elderly patient: case report An 81-year-old man with type 2 diabetes mellitus, who was receiving metformin [Glucophage] 850mg three times daily and insulin glargine, was hospitalised with sudden tiredness, vertigo, cyanosis and lethargy [duration of treatment to reaction onset not stated]. Arterial blood gas analysis revealed metabolic acidosis, hypoxaemia and hypercapnia. He was transferred to an ICU, intubated and ventilated. His blood gas values improved the following day and he was weaned off the ventilator. His vital signs, blood sugar and lactate levels subsequently stabilised, his therapy regimen was rearranged, and he was discharged on hospital day 4. Author comment: "Dyspnea, acidosis, and hypoxia seen in the patient were thought to be due to lactic acidosis which may rarely occur when metformin is used." Cezur M, et al. A clinical case of lactic acidosis development in a diabetic patient taking metformin. Anesteziologiia i Reanimatologiia : 74-76, No. 2, Mar-Apr 2009 801158138 [Russian; summarised from an abstract.] - Turkey
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Reactions 9 Jan 2010 No. 1283
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