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Nishihama K, Maki K, Okano Y, et al. A case of type 2 diabetes mellitus with metformin-associated lactic acidosis initially presenting the appearance of a sulfonylurea-related hypoglycemic attack. Acute Med Surg. 2016;4(1):123-126doi: 10.1002/ams2.233.
Nishihama, K., Maki, K., Okano, Y., Hashimoto, R., Hotta, Y., Uemura, M., Yasuma, T., Suzuki, T., Hayashi, T., Ishikawa, E., Yano, Y., Gabazza, E. C., Ito, M., & Takei, Y. (2017). A case of type 2 diabetes mellitus with metformin-associated lactic acidosis initially presenting the appearance of a sulfonylurea-related hypoglycemic attack. Acute medicine & surgery, 4(1), 123-126. https://doi.org/10.1002/ams2.233
Nishihama, Kota, et al. "A case of type 2 diabetes mellitus with metformin-associated lactic acidosis initially presenting the appearance of a sulfonylurea-related hypoglycemic attack." Acute medicine & surgery vol. 4,1 (2017): 123-126. doi: https://doi.org/10.1002/ams2.233
Nishihama K, Maki K, Okano Y, Hashimoto R, Hotta Y, Uemura M, Yasuma T, Suzuki T, Hayashi T, Ishikawa E, Yano Y, Gabazza EC, Ito M, Takei Y. A case of type 2 diabetes mellitus with metformin-associated lactic acidosis initially presenting the appearance of a sulfonylurea-related hypoglycemic attack. Acute Med Surg. 2016 Aug 03;4(1):123-126. doi: 10.1002/ams2.233. eCollection 2017 Jan. PMID: 29123848; PMCID: PMC5667282.
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Acute Med Surg. 2016 Aug 03;4(1):123-126. doi: 10.1002/ams2.233. eCollection 2017 Jan.

A case of type 2 diabetes mellitus with metformin-associated lactic acidosis initially presenting the appearance of a sulfonylurea-related hypoglycemic attack.

Acute medicine & surgery

Kota Nishihama, Kanako Maki, Yuko Okano, Rei Hashimoto, Yasuhiro Hotta, Mei Uemura, Taro Yasuma, Toshinari Suzuki, Toyomi Hayashi, Eiji Ishikawa, Yutaka Yano, Esteban C Gabazza, Masaaki Ito, Yoshiyuki Takei

Affiliations

  1. Department of Diabetes, Metabolism and Endocrinology Mie University Graduate School of Medicine Tsu Japan.
  2. Department of Diabetes and Endocrinology Mie University Hospital Tsu Japan.
  3. Department of Immunology Mie University Graduate School of Medicine Tsu Japan.
  4. Department of Cardiology and Nephrology Mie University Graduate School of Medicine Tsu Japan.
  5. Department of Gastroenterology and Hepatology Mie University Graduate School of Medicine Tsu Japan.

PMID: 29123848 PMCID: PMC5667282 DOI: 10.1002/ams2.233

Abstract

CASE: A 64-year-old Japanese woman with diabetes mellitus was admitted for hypoglycemia. Her diabetes had been under good control with glimepiride, voglibose, exenatide, and metformin for a few years. Although overt proteinuria was observed, the serum creatinine values were within normal range during the routine outpatient follow-up. Hypoglycemic attack caused by glimepiride and loss of appetite by urinary tract infection were diagnosed. Then, metformin-associated lactic acidosis with acute renal failure caused by dehydration was detected.

OUTCOME: Her condition was improved by continuous veno-venous hemodiafiltration and hemodialysis, known to be useful to remove metformin.

CONCLUSION: We reported a case of metformin-associated lactic acidosis with hypoglycemia during routine treatment of diabetes that was successfully rescued by early renal replacement therapy.

Keywords: Diabetes mellitus; hemodialysis; hypoglycemia; lactic acidosis; metformin

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