ReviewClinical drug investigation2017
Lactate Levels with Chronic Metformin Use: A Narrative Review.
Review in Clinical drug investigation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 22 citations in OpenAlex.
- The nephroprotective effect of metformin with cisplatin in bladder cancer: randomized clinical trial.International urology and nephrology · 2025Trial
- Association is not yet an indication: concerns about monitoring claims and residual confounding in outpatient metformin-associated lactate elevation.Therapeutic advances in endocrinology and metabolism · 2026Article
- Factors potentiating risk of higher lactate level associated with metformin therapy: a cross-sectional study in an ambulatory care setting.Therapeutic advances in endocrinology and metabolism · 2026Article
- Metformin and feeding increase levels of the appetite-suppressing metabolite Lac-Phe in humans.Nature metabolism · 2024Article
- Redox state and altered pyruvate metabolism contribute to a dose-dependent metformin-induced lactate production of human myotubes.American journal of physiology. Cell physiology · 2023Article
- Lipids Alterations Associated with Metformin in Healthy Subjects: An Investigation Using Mass Spectrometry Shotgun Approach.International journal of molecular sciences · 2022Article
- AMPK-mediated potentiation of GABAergic signalling drives hypoglycaemia-provoked spike-wave seizures.Brain : a journal of neurology · 2022Article
- Metformin: When Should We Fear Lactic Acidosis?International journal of molecular sciences · 2022Review
- Targeting Myotonic Dystrophy Type 1 with Metformin.International journal of molecular sciences · 2022Review
- Recommendations for Practical Use of Metformin, a Central Pharmacological Therapy in Type 2 Diabetes.Clinical diabetes : a publication of the American Diabetes Association · 2022Article
- The Function of Metformin in Aging-Related Musculoskeletal Disorders.Frontiers in pharmacology · 2022Review
- A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan.Frontiers in endocrinology · 2021Review
- Metformin and cardiorenal outcomes in diabetes: A reappraisal.Diabetes, obesity & metabolism · 2020Review
- Metformin as Anti-Aging Therapy: Is It for Everyone?Trends in endocrinology and metabolism: TEM · 2019Review
- Metformin exposure and the incidence of lactic acidosis in critically ill patients with T2DM: A retrospective cohort study.Science progressArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Metformin has been associated with lactic acidosis. Lactate levels are not commonly tested in clinical practice, and it is unclear to what extent metformin would typically increase lactate levels with chronic use. The aim of this review was to determine whether regular monitoring of the plasma lactate level would be beneficial in avoiding lactate accumulation and, ultimately, minimising the incidence of lactic acidosis in metformin-treated patients.A comprehensive search of PubMed, Embase, Web of Science, Cochrane and International Pharmaceutical Abstracts databases covering the period up to 30 May 2017 was performed. Search terms included combinations of terms and keywords, including "metformin", "lactate", "lactic acid" and "lactic acidosis". Cases series of lactic acidosis or metformin-associated lactic acidosis were excluded.Of 1539 potentially relevant articles, a total of 52 reported lactate levels from routine/regular pathological tests in metformin users. The studies were subdivided into four themes, regarding metformin usage and the reported lactate levels in patients who: (1) did not have contraindications to the use of metformin; (2) had contraindications, or renal impairment but without other contraindications; (3) exercised; or (4) also received any nucleoside reverse transcriptase inhibitor. Studies have reported that metformin treatment could increase lactate level of users. However, most results showed that the lactate level remained in the normal range.No definitive conclusions on the benefits of regular lactate monitoring in patients taking metformin can be made. Future research on larger populations focusing on the measurement of lactate levels with continuous metformin use is warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.