Q&A

Metformin-induced lactic acidosis extremely rare

J Fam Pract. 2004 April;53(4):261-268
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  • CLINICAL QUESTION: What is the risk of lactic acidosis accompanying metformin therapy for patients with type 2 diabetes?
  • STUDY DESIGN: Systematic review
  • SETTING: Outpatient (any)
  • SYNOPSIS: It’s tricky to try to prove the nonexistence of a phenomenon. The adage holds: Absence of proof is not proof of absence. So, how much absence of proof do we need?
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BOTTOM LINE

The link between metformin and lactic acidosis, when used as prescribed, is tenuous. The bigger question is whether lactic acidosis risk truly increases when we relax criteria and give it to patients previously forbidden to take it. (LOE=1a)

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