The Serum Lactate Level and Other Factors in Metformin Poisoning: A Case Series

Document Type : Short Communication

Authors

1 Assistant Professor, Clinical Toxicology Fellowship, Emergency Department, Alborz University of Medical Science, Karaj, Iran

2 Assistant Professor, Department of Pharmacology, School of Medicine AND Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran

3 Board Certificate of Emergency Medicine, Clinical Toxicology Fellowship, Emergency Department, Alborz University of Medical Sciences, Karaj, Iran

4 Associate Professor, Toxicological Research Center, Department of Clinical Toxicology, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran

10.48305/jims.v41.i747.1104

Abstract

Background: Identifying the effective factors in the progression toward lactic acidosis and death is essential in improving the treatment of Metformin-poisoned patients. This study investigates the blood lactate level in Metformin-poisoned patients and the factors affecting it.
Methods: This was a case series study in two referral clinical toxicology centers in Iran for one year. 16 patients were included in the study. The questionnaire was filled out based on the demographic characteristics of the person, vital signs, poisoning symptoms, blood biochemistry, blood gases, blood sugar, and treatments. The lactate level was measured 6-12-24 hours later.
Findings: Three cases (18.8%) were male and 13 (81.3%) were female. The average age was 30.13 ± 16.22 years. One case of hypoglycemia, three cases of metabolic acidosis, and three cases of creatinine level above 1.2 were observed. The initial pH and bicarbonate were predictors of the lactate level. No cases of death or lactic acidosis were observed.
Conclusion: Blood pH and bicarbonate can be used as predictors of serum lactate increase. Also, this study showed that the probability of death and lactic acidosis with metformin is very low.

Highlights

Hoorvash Faraji Dana: Google Scholar, PubMed

Maral Ramezani: Google Scholar, PubMed

Mitra Rahimi: Google Scholar, PubMed

Keywords

Main Subjects

References

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Journal of Isfahan Medical School
Volume 41, Issue 747
3rd Week, February
January and February 2024
Pages 1108-1104

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History

  • Receive Date: 26 October 2023
  • Revise Date: 19 February 2024
  • Accept Date: 20 February 2024

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