Metformin-associated Lactic Acidosis with Hypoglycemia during the COVID-19 Pandemic: A Case Report

Kana Takayama; Yoshinari Obata; Yumiko Maruo; Hiroki Yamaguchi; Motohiro Kosugi; Yoko Irie; Yoji Hazama; Tetsuyuki Yasuda

doi:10.2169/internalmedicine.9179-21

This article has now been updated. Please use the final version.

Metformin-associated Lactic Acidosis with Hypoglycemia during the COVID-19 Pandemic: A Case Report

Kana Takayama, Yoshinari Obata, Yumiko Maruo, Hiroki Yamaguchi, Motohiro Kosugi, Yoko Irie, Yoji Hazama, Tetsuyuki Yasuda

Author information

Kana Takayama
Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
Yoshinari Obata
Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
Yumiko Maruo
Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
Hiroki Yamaguchi
Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
Motohiro Kosugi
Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
Yoko Irie
Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
Yoji Hazama
Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan
Tetsuyuki Yasuda
Department of Diabetes, Metabolism and Endocrinology, Osaka Police Hospital, Japan

Keywords: metformin, lactic acidosis, hypoglycemia, alcohol, COVID-19

JOURNAL OPEN ACCESS Advance online publication

Article ID: 9179-21

DOI https://doi.org/10.2169/internalmedicine.9179-21

The final version of this article is now available: Vol. 61 (2022), No. 15 pp. 2333-2337

Details

Abstract

Metformin-associated lactic acidosis (MALA) is an extremely rare but life-threatening adverse effect of metformin treatment. The lifestyle changes associated with the coronavirus disease 2019 (COVID-19) pandemic may increase the potential risk of MALA development in patients with diabetes. We herein report a 64-year-old Japanese man taking a small dose of metformin who presented with MALA accompanied by hypoglycemia secondary to increased alcohol consumption triggered by lifestyle changes during the pandemic. Physicians should prescribe metformin judiciously to prevent MALA development and pay close attention to lifestyle changes in patients at risk for MALA during the COVID-19 pandemic.

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