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  • Review: metformin does not increase fatal or non-fatal lactic acidosis or blood lactate concentrations in type 2 diabetes mellitus

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Therapeutics
Review: metformin does not increase fatal or non-fatal lactic acidosis or blood lactate concentrations in type 2 diabetes mellitus

https://doi.org/10.1136/ebm.7.6.176

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    ; Salpeter S, Greyber E, Pasternak G, et al.Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Cochrane Database Syst Rev 2002(2):CD002967 (latest version 27 Feb 2002)..

    
 
 QUESTION: In patients with type 2 diabetes mellitus, does metformin increase the risk for fatal and non-fatal lactic acidosis or increase blood lactate concentrations compared with placebo or other hypoglycaemic treatments?

    Data sources

    Studies were identified by searching the Cochrane Library (to April 2000), Medline (1966–2000), EMBASE/Excerpta Medica (1974–2000), Oldmedline, Reactions (1983 to May 2000), Index Medicus (1959–1965), and bibliographies of identified papers and by contacting investigators.

    Study selection

    Clinical trials and cohort studies were selected if they included patients with type 2 diabetes, lasted ≥1 month, compared metformin alone or combined with other treatments with placebo or any other hypoglycaemic treatment, and reported the number of patients and duration of treatment.

    Data extraction

    Data were extracted on study methods and quality, participants, interventions, and outcomes. Attempts were made to contact authors for missing data.

    Main results

    176 studies (118 prospective …

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    Footnotes

    • Source of funding: not stated.

    • For correspondence: Dr S Salpeter, Stanford University and Santa Clara Valley Medical Center, San Jose, CA, USA. Email shelley.salpeter{at}hhs.co.santa-clara.ca.us.