Literature DB >> 27504911

Metformin use and risk of lactic acidosis in people with diabetes with and without renal impairment: a cohort study in Denmark and the UK.

L Li1, S Jick1, C Gopalakrishnan1, U Heide-Jørgensen2, H Nørrelund2, H T Sørensen2, C F Christiansen2, V Ehrenstein2.   

Abstract

AIMS: To assess risk of lactic acidosis among metformin users compared with other glucose-lowering agent users, according to renal function.
METHODS: Using routine registries and databases, we conducted a cohort study. Of 43 580 metformin and 37 788 other glucose-lowering agent users in northern Denmark and 102 688 metformin and 28 788 other glucose-lowering agent users in the UK during 2001-2011, we identified lactic acidosis using diagnostic codes. We calculated the incidence rates of lactic acidosis in metformin and other glucose-lowering agent users overall and according to baseline estimated GFR (eGFR) levels.
RESULTS: In Denmark, the incidence rates of lactic acidosis were 11.6 (95% CI 7.0-18.1) and 1.8 (95% CI 0.4-5.4) per 100 000 person-years of metformin use and of other glucose-lowering agent use, respectively. In the UK, the corresponding lactic acidosis incidence rates were 6.8 (95% CI 4.6-9.6) and 1.0 (95% CI 0.01-5.7) per 100 000 person-years of metformin use and of other glucose-lowering agent use. The incidence rates increased with decreasing baseline eGFR in both countries. Of the metformin-exposed people with lactic acidosis, 37% in Denmark and 34% in the UK experienced a decline in renal function in the year before the diagnosis.
CONCLUSIONS: Risk of lactic acidosis was higher in metformin users than in other glucose-lowering agent users, and increased with decreasing eGFR, although this could be attributable to surveillance bias; however, diagnosed lactic acidosis was rare and can occur regardless of renal function.
© 2016 Diabetes UK.

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Year:  2016        PMID: 27504911     DOI: 10.1111/dme.13203

Source DB:  PubMed          Journal:  Diabet Med        ISSN: 0742-3071            Impact factor:   4.359


  8 in total

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Review 2.  Efficacy and safety of metformin in the management of type 2 diabetes mellitus in older adults: a systematic review for the development of recommendations to reduce potentially inappropriate prescribing.

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6.  Prognostic impact of elevated lactate levels on mortality in critically ill patients with and without preadmission metformin treatment: a Danish registry-based cohort study.

Authors:  Rene A Posma; Trine Frøslev; Bente Jespersen; Iwan C C van der Horst; Daan J Touw; Reimar W Thomsen; Maarten W Nijsten; Christian F Christiansen
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8.  Reduced lactic acidosis risk with Imeglimin: Comparison with Metformin.

Authors:  Pierre Theurey; Guillaume Vial; Eric Fontaine; Pierre-Axel Monternier; Pascale Fouqueray; Sébastien Bolze; David E Moller; Sophie Hallakou-Bozec
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  8 in total

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