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Review: metformin does not increase risk of lactic acidosis or increase lactate levels in type 2 diabetes

Clinical impact ratings GP/FP/Primary care IM/Ambulatory care Internal medicine Endocrine

Key Words: diabetes mellitus (type II) • acidosis (lactic) • metformin

The first 150 words of the full text of this article appear below.

METHODS
Data sources: the Cochrane Library, Medline, Reactions, and EMBASE/Excerpta Medica (up to March 2002); references of identified articles and reviews; abstracts of clinical conferences; and authors of relevant studies and manufacturers of metformin.

Study selection and assessment: randomised controlled trials (RCTs) or cohort studies 1 month in duration that compared metformin, alone or in combination in other treatments, with placebo or another glycaemic lowering intervention for type 2 diabetes. Methodological quality was assessed using criteria that considered randomisation procedure, blinding, and withdrawals and dropouts.

Outcomes: fatal lactic acidosis, non-fatal lactic acidosis, and blood lactate levels for metformin compared with placebo or other non-biguanide therapies, and for metformin compared with phenformin.

MAIN RESULTS
194 studies (126 RCTs and 68 cohort studies, n = 56 692, mean age 57 y, 61% men) met the selection criteria. Mean trial duration was 2.1 years. Metformin was administered in daily doses of 1–3 g and was titrated . . . [Full text of this article]

James A Kruse, MD

Wayne State University School of Medicine
Detroit, Michigan, USA