PT  - JOURNAL ARTICLE
AU  - Emma Jane Fadden
AU  - Christian Longley
AU  - Tushar Mahambrey
TI  - Metformin-associated lactic acidosis
AID  - 10.1136/bcr-2020-239154
DP  - 2021 Jul 01
TA  - BMJ Case Reports
PG  - e239154
VI  - 14
IP  - 7
4099  - http://casereports.bmj.com/content/14/7/e239154.short
4100  - http://casereports.bmj.com/content/14/7/e239154.full
SO  - BMJ Case Reports2021 Jul 01; 14
AB  - A 58-year-old female with known type 2 diabetes mellitus continued to take her usual medications, including metformin, an ACE inhibitor and a non-steroidal anti-inflammatory drug, while suffering from diarrhoea and vomiting. On presentation to the emergency department, she was found to have a profound lactic acidosis, cardiovascular instability and acute kidney injury. Despite a pH of 6.6, lactate of 14 mmol/L and a brief asystolic cardiac arrest, supportive treatment and the use of renal replacement therapy resulted in rapid improvement in her acid–base abnormalities and haemodynamic parameters. Metformin-associated lactic acidosis is a rare but life-threatening complication of diabetes management. Patient education and awareness amongst clinicians are paramount in the prevention and treatment of this condition.