Metformin-associated Lactic Acidosis Induced by Excessive Alcohol Consumption

A 65-year-old man with type 2 diabetes who was being treated with metformin developed lactic acidosis following excessive alcohol consumption. While an impaired renal function is a major risk factor for metformin-associated lactic acidosis (MALA), the patient's basal renal function was normal....

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Bibliographic Details
Published in:Internal Medicine 2024/06/15, Vol.63(12), pp.1745-1749
Main Authors: Yamagishi, Hirofumi, Sekiguchi, Naoki, Hirano, Akiko, Oshima, Atsushi, Imai, Taihei
Format: Article
Language:English
Subjects:
Acidosis
Acidosis, Lactic - chemically induced
Aged
alcohol
Alcohol Drinking - adverse effects
Alcohol use
Alcoholism - complications
Case reports
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - drug therapy
Humans
Hypoglycemic Agents - adverse effects
Lactic acidosis
Male
Metformin
Metformin - adverse effects
Nicotinamide
Renal function
Risk factors
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Summary:A 65-year-old man with type 2 diabetes who was being treated with metformin developed lactic acidosis following excessive alcohol consumption. While an impaired renal function is a major risk factor for metformin-associated lactic acidosis (MALA), the patient's basal renal function was normal. Alcohol misuse reduces lactate clearance by utilizing nicotinamide adenine dinucleotides for ethanol oxidation, thereby promoting vulnerability to MALA. Nevertheless, as MALA in individuals with a normal renal function is extremely rare, the clinical picture of alcohol-induced MALA is unclear. We delineate the clinical picture and discuss the pathogenesis of alcohol-induced MALA based on our experience and previous case reports.
ISSN:0918-2918
1349-7235
1349-7235
DOI:10.2169/internalmedicine.2707-23