Parisa Tajdini
1,2, Majid Foroutan
3,4* 
1 Department of Pediatrics, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
2 Clinical Research Development Unit, Amir-Al-Momenin Educational, Research and Therapeutic Hospital, Semnan University of Medical Sciences, Semnan, Iran
3 Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
4 Clinical Research Development Unit, Kowsar Educational, Research and Therapeutic Hospital, Semnan University of Medical Sciences, Semnan, Iran
Abstract
Risk factors for metformin-associated lactic acidosis (MALA) include impaired renal function, liver disease, heart failure, sepsis, and alcohol abuse. Patients with these risk factors should be closely monitored while on metformin therapy, and the dose should be adjusted accordingly. It is also important to screen patients for these risk factors before starting metformin therapy. In addition, patients should be educated on the symptoms of lactic acidosis, such as abdominal pain, nausea, vomiting, and muscle weakness, and advised to seek medical attention immediately if they experience any of these symptoms. Overall, early recognition and appropriate management of MALA can improve patient outcomes and prevent mortality.
Keywords: Metformin, Renal function, Metformin-associated lactic acidosis, Acidosis, Endstage renal disease, Glomerular filtration rate, Acute kidney injury, Type 2 diabetes, Chronic kidney disease