Copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Aug 15, 2022; 13(8): 654-664
Published online Aug 15, 2022. doi: 10.4239/wjd.v13.i8.654
Published online Aug 15, 2022. doi: 10.4239/wjd.v13.i8.654
Metformin toxicity: A meta-summary of case reports
Deven Juneja, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi 110017, India
Prashant Nasa, Department of Critical Care Medicine, NMC Specialty Hospital, Dubai 7832, United Arab Emirates
Ravi Jain, Department of Critical Care Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur 302022, India
Author contributions: Juneja D contributed to acquisition of data, analysis and interpretation of data, drafting the article, final approval; Nasa P contributed to acquisition of data, analysis and interpretation of data, drafting the article, final approval; Jain R contributed to interpretation of data, revising the article, final approval.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Deven Juneja, DNB, FCCP, MBBS, Director, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Received: March 22, 2022
Peer-review started: March 22, 2022
First decision: May 11, 2022
Revised: May 17, 2022
Accepted: July 25, 2022
Article in press: July 25, 2022
Published online: August 15, 2022
Peer-review started: March 22, 2022
First decision: May 11, 2022
Revised: May 17, 2022
Accepted: July 25, 2022
Article in press: July 25, 2022
Published online: August 15, 2022
Core Tip
Core Tip: Metformin may be associated with significant toxicity, even when used in therapeutic doses, of which metformin associated lactic acidosis is the most commonly reported toxicity. These patients may have favourable outcomes in spite of consumption of high doses, severe acidosis, and high serum lactate and metformin concentrations. Early aggressive supportive care, use of renal replacement therapy for toxin removal and organ support may help in improving outcomes.