Open AccessA case of type 2 diabetes mellitus with metformin‐associated lactic acidosis initially presenting the appearance of a sulfonylurea‐related hypoglycemic attack
Author(s) -
Nishihama Kota,
Maki Kanako,
Okano Yuko,
Hashimoto Rei,
Hotta Yasuhiro,
Uemura Mei,
Yasuma Taro,
Suzuki Toshinari,
Hayashi Toyomi,
Ishikawa Eiji,
Yano Yutaka,
Gabazza Esteban C.,
Ito Masaaki,
Takei Yoshiyuki
Publication year - 2017
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.233
Subject(s) - metformin , medicine , lactic acidosis , glimepiride , hypoglycemia , diabetes mellitus , exenatide , glycosuria , type 2 diabetes , sulfonylurea , acidosis , renal replacement therapy , gastroenterology , type 2 diabetes mellitus , endocrinology
Case A 64‐year‐old Japanese woman with diabetes mellitus was admitted for hypoglycemia. Her diabetes had been under good control with glimepiride, voglibose, exenatide, and metformin for a few years. Although overt proteinuria was observed, the serum creatinine values were within normal range during the routine outpatient follow‐up. Hypoglycemic attack caused by glimepiride and loss of appetite by urinary tract infection were diagnosed. Then, metformin‐associated lactic acidosis with acute renal failure caused by dehydration was detected. Outcome Her condition was improved by continuous veno‐venous hemodiafiltration and hemodialysis, known to be useful to remove metformin. Conclusion We reported a case of metformin‐associated lactic acidosis with hypoglycemia during routine treatment of diabetes that was successfully rescued by early renal replacement therapy.