Evidence map›Paper›PMID 33472652›Full record

ArticleJournal of medical case reports2021

The usefulness of measuring the anion gap in diagnosing metformin-associated lactic acidosis: a case series.

Jesus Ruiz-Ramos, Laura Lozano-Polo, Ana Juanes-Borrego, Iván Agra-Montava, Mireia Puig-Campmany, María Antonia Mangues-Bafalluy

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Article in Journal of medical case reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Jesus Ruiz-RamosPharmacy Department, Hospital Santa Creu i Sant Pau, C/San Quintín 89, 08041, Barcelona, Spain. Jruizr@santpau.cat.ORCID http://orcid.org/0000-0002-0008-641X
Laura Lozano-PoloEmergency Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
Ana Juanes-BorregoPharmacy Department, Hospital Santa Creu i Sant Pau, C/San Quintín 89, 08041, Barcelona, Spain.
Iván Agra-MontavaEmergency Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
Mireia Puig-CampmanyEmergency Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
María Antonia Mangues-BafalluyPharmacy Department, Hospital Santa Creu i Sant Pau, C/San Quintín 89, 08041, Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetformin-associated lactic acidosis (MALA) is a widely documented adverse event of metformin. Despite being considered one of the main causes of metabolic acidosis, the association between an anion gap and MALA diagnosis is still uncertain. CASE PRESENTATION: Cases involving six Caucasian patients with suspected MALA who were admitted to the emergency department were analysed. All these patients presented with pH values < 7.35, lactate levels > 2 mmol/L, and estimated glomerular filtration < 30 mL/min. Metformin plasma concentrations were > 2.5 mg/L in all the patients. The highest metformin concentrations were not found in the patients with the highest lactate levels. The anion gap values ranged from 12.3 to 39.3, with only two patients exhibiting values > 14.

conclusionsIn patients with MALA, there is a significant variability in the anion gap values, which is not related to the level of metformin accumulation, and therefore, it is doubtful whether measuring anion gaps is useful as an approach for MALA diagnosis.

Indexed as

Acid-Base EquilibriumAcidosis, LacticAgedAged, 80 and overAnionsCationsDiabetes Mellitus, Type 2FemaleHumansHypoglycemic AgentsLactic AcidMaleMetforminMiddle AgedAnionsCationsHypoglycemic AgentsLactic AcidMetforminAcidosisAcute renal failureAnion gapDiabetesEmergency careMetformin

Identifiers

PMID33472652
PMCPMC7818914

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