Metformin intoxication – three clinical cases with lethal outcomes. Recommen- dations to the general practitioner
General Medicine,2023, 25(1), 45-48.
N. Grigorov1, B. Grigorova2
1 Clinic of Internal Medicine, Military Medical Academy ‒ Sofia
2 Clinic of Cardiology, Military Medical Academy ‒ Sofia
Abstract. Metformin is a widely prescribed medication, a first line therapy for type 2 diabetes mellitus (DM). Although it has many positive effects on the human body, it is important to mention that it is eliminated mainly thorough the kidney and its dose has to be adjusted according to its function. Otherwise, the patient may develop metformin intoxication, leading to a multi-organ failure and a potential fatal outcome. The aim of this article is to emphasize that in cases of treatment with metformin the kidney’s function has to be strictly monitored by the endocrinologists and general practitioners (GPs). The dose has to be adjusted or if necessary, the treatment has to be stopped. The methods that we used are a retrospective and an analytical method. We present three clinical cases of metformin intoxication within a four-month period from MMA ‒ Sofia, which ended with lethal outcomes. Conclusions: When metformin is used for treatment, the creatinine and kidney’s function have to be monitored by GPs. They also have to inform the patients about the connection between the use of this medication and the kidney’s function.
Key words: DM type 2, metformin, kidney’s function, metformin intoxication, lactic acidosis, monitoring
Address for correspondence: Assoc. Prof. Nedyalko Grigorov, MD, PhD, е-mail: n_grigorov@gbg.bg