Metformin Associated Lactic Acidosis Not As Rare As We Think?

Abstract

Metformin Associated Lactic Acidoisis (MALA) has been reported to be a very rare but serious side effect of metformin treatment with a fatality rate of 50%. However, with the number of patients on metformin increasing the incidence of MALA is likely to increase. We aim to raise the awareness of MALA and prompt acute physicians to consider this diagnosis in the acutely unwell diabetic patient on metformin. We present 3 cases that presented with MALA in the course of 6 months, all of whom survived. We discuss metformin, its effects and lactic acidosis. We encourage effective prompt resuscitation of these individuals to increase survival.

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