Article
Prevalence of risk determinants for metformin-associated lactic acidosis and metformin utilization in the Study of Health in Pomerania
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Published: | September 6, 2007 |
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Background: Risk determinants for the life threatening complication of metformin-associated lactic acidosis are frequently disregarded. The first aim of this study was to investigate the prevalence of currently stated risk determinants in subjects with type 2 diabetes mellitus who use metformin compared to subjects without metformin treatment. The second aim was to estimate the proportion of subjects with alternative drug-treatment who had no risk determinants but would probably benefit from metformin.
Methods: The Study of Health in Pomerania is a population-based health survey including 339 subjects with type 2 diabetes mellitus. Risk determinants were assessed by computer-assisted personal interview and ultrasound.
Results: Among subjects with type 2 diabetes mellitus, n=92 (28.6%) were treated with metformin, n=162 (50.3%) with alternative medication, and n=68 (21.1%) with diet. The prevalence of at least one risk determinant was 62% for the metformin-users. There was no difference regarding number and type of risk determinants. Heart failure, angina pectoris, and liver disorders presented the most frequent risk determinants.
Conclusions: Risk determinants for metformin-associated lactic acidosis are largely disregarded. A better selection of patients can result in a metformin utilization in one forth of subjects on type 2 diabetes mellitus related drug treatment, even without subjects who have risk determinants. A more standardized definition of risk determinants seems to be necessary.