Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review
Introduction: Metformin (a biguanide) for the treatment of Type 2 Diabetes Mellitus is widely used worldwide. However, is a double-edged sword for critically ill patients. One of the most important problems with its use is the risk of developing metformin-associated lactic acidosis (MALA). We presen...
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| Format: | Article |
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Emergency Department of Hospital San Pedro (Logroño, Spain)
2025-01-01
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| Series: | Iberoamerican Journal of Medicine |
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| Online Access: | https://doi.org/10.53986/ibjm.2025.0007 |
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| author | Enrique Chicote-Álvarez Helena Camino-Ferró Marlene Feo-González Maite Arlabán-Carpintero Natalia Gloria Lizama-Gómez |
| author_facet | Enrique Chicote-Álvarez Helena Camino-Ferró Marlene Feo-González Maite Arlabán-Carpintero Natalia Gloria Lizama-Gómez |
| author_sort | Enrique Chicote-Álvarez |
| collection | DOAJ |
| description | Introduction: Metformin (a biguanide) for the treatment of Type 2 Diabetes Mellitus is widely used worldwide. However, is a double-edged sword for critically ill patients. One of the most important problems with its use is the risk of developing metformin-associated lactic acidosis (MALA). We present our 10-year experience with lactic acidosis attributed to MALA as well as a review of the literature.
Material and methods: We reviewed admissions to the Intensive Care Unit (ICU) of a secondary-level hospital (630 inpatient beds) with diagnoses of "metabolic acidosis," "lactic acidosis," and "metformin-associated lactic acidosis" from January 2014 to June 2024. Data were collected from patients' electronic medical records and entered into an Excel® document for analysis.
Results: Of the total 72 cases reviewed, 11 were included. Nine cases were male (81.82%), with a mean age of 75.36 years (ages ranging from 63 to 80 years). None of the cases had a history of chronic kidney disease, but all presented with acute renal failure. Renal replacement therapies (RRT) were used in all cases, with 6 patients initially treated with and 9 patients with conventional hemodialysis. The mortality rate was 0%. However, in the literature MALA presents a mortality exceeding 10% according to several studies.
Conclusions: MALA is a very serious condition and early diagnosis is very important. The use of renal replacement therapies is of Paramount importance as well as clinical suspicion. |
| format | Article |
| id | doaj-art-79afbf15ff8f4c1bb7a5869964307c00 |
| institution | OA Journals |
| issn | 2695-5075 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Emergency Department of Hospital San Pedro (Logroño, Spain) |
| record_format | Article |
| series | Iberoamerican Journal of Medicine |
| spelling | doaj-art-79afbf15ff8f4c1bb7a5869964307c002025-08-20T02:12:36ZengEmergency Department of Hospital San Pedro (Logroño, Spain)Iberoamerican Journal of Medicine2695-50752025-01-0172424510.53986/ibjm.2025.0007Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a reviewEnrique Chicote-Álvarez0Helena Camino-Ferró1Marlene Feo-González2Maite Arlabán-Carpintero3Natalia Gloria Lizama-Gómez4Department of Intensive Care Medicine, Hospital San Pedro, Logroño, SpainDepartment of Intensive Care Medicine, Hospital San Pedro, Logroño, SpainDepartment of Intensive Care Medicine, Hospital San Pedro, Logroño, SpainDepartment of Intensive Care Medicine, Hospital San Pedro, Logroño, SpainDepartment of Pharmacy, Hospital San Pedro, Logroño, SpainIntroduction: Metformin (a biguanide) for the treatment of Type 2 Diabetes Mellitus is widely used worldwide. However, is a double-edged sword for critically ill patients. One of the most important problems with its use is the risk of developing metformin-associated lactic acidosis (MALA). We present our 10-year experience with lactic acidosis attributed to MALA as well as a review of the literature. Material and methods: We reviewed admissions to the Intensive Care Unit (ICU) of a secondary-level hospital (630 inpatient beds) with diagnoses of "metabolic acidosis," "lactic acidosis," and "metformin-associated lactic acidosis" from January 2014 to June 2024. Data were collected from patients' electronic medical records and entered into an Excel® document for analysis. Results: Of the total 72 cases reviewed, 11 were included. Nine cases were male (81.82%), with a mean age of 75.36 years (ages ranging from 63 to 80 years). None of the cases had a history of chronic kidney disease, but all presented with acute renal failure. Renal replacement therapies (RRT) were used in all cases, with 6 patients initially treated with and 9 patients with conventional hemodialysis. The mortality rate was 0%. However, in the literature MALA presents a mortality exceeding 10% according to several studies. Conclusions: MALA is a very serious condition and early diagnosis is very important. The use of renal replacement therapies is of Paramount importance as well as clinical suspicion.https://doi.org/10.53986/ibjm.2025.0007metforminlactic acidosiscritical care |
| spellingShingle | Enrique Chicote-Álvarez Helena Camino-Ferró Marlene Feo-González Maite Arlabán-Carpintero Natalia Gloria Lizama-Gómez Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review Iberoamerican Journal of Medicine metformin lactic acidosis critical care |
| title | Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review |
| title_full | Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review |
| title_fullStr | Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review |
| title_full_unstemmed | Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review |
| title_short | Metformin-Associated Lactic Acidosis (MALA). Our experiencie and a review |
| title_sort | metformin associated lactic acidosis mala our experiencie and a review |
| topic | metformin lactic acidosis critical care |
| url | https://doi.org/10.53986/ibjm.2025.0007 |
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