A serious diagnosis in geriatric patient - metformin-associated lactic acidosis. Do we consider it sufficiently?
Abstract
Metformin is an oral antidiabetic drug of first choice with a positive effect on type 2 diabetes mellitus control as well as protective action on cardiovascular system. With respect to renal impairment, metformin should be prescribed in reduced doses or is even contraindicated due to high risk of metformin accumulation and/or lactic acidosis development.
Till this day, this complication remains a risk especially in geriatric patients with reduced reserve capacity, who often suffer from numerous chronic diseases which can deteriorate due to a minor event. This fact should be remembered by every doctor, who should also be able to decide whether to terminate metformin therapy or not.
In this article we present case studies of four patients of metabolic ICU treated with metformin-associated lactic acidosis.