Blood Lactate Levels in Diabetics Receiving Long-term 1, 1-Dimethyl-biguanide Treatment
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In 1977, the clinical use of phenformin for treating diabetes mellitus was prohibited since this substance was found to cause lactic acidosis.<BR>Due to the strong clinical toxicity of phenformin, we used 1, 1-dimethyl-biguanide (metformin) as a biguanide (BG) preparation. The present study was undertaken to determine the effects of longterm metformin administration on blood lactate levels, arterial pH and anion gap in diabetic patients.<BR>Thirty-five subjects receiving oral administrations of metformin, 750mg/day, for more than 3yr (BG-group), 10 normal subjects, and 94 diabetics treated without using BG, were examined.<BR>A significant increase in blood lactate levels and anion gap, and a significant decrease in arterial pH were observed in the BG-group when compared with the other groups not receiving BG. However, the extent of the observed increase in blood lactate level (21.0mg/dl), the minimum arterial pH (7.35), and the maximum anion gap (7.1mEq/l) in the BG-group were outside the limits of the criteria for the diagnosis of lactic acidosis: blood lactate>6mEq/l (≅54.2mg/dl), arterial pH <7.33, and anion gap> 20mEq/l.<BR>It is concluded therefore that although no patient receiving metformin therapy appeared to develop lactic acidosis, blood lactate levels and arterial pH should be carefully and regularly monitored in patients during metformin therapy since their blood lactate could easily be enhanced through various causes and so result in lactic acidosis.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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