ArticleTherapeutic advances in drug safety2026
Metformin-associated lactic acidosis in an elderly diabetic patient without classical risk factors: a case report.
Article in Therapeutic advances in drug safety, 2026. 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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Abstract
Metformin is a cornerstone medication and first-line therapy for type 2 diabetes mellitus (T2DM), with a well-established safety profile and widespread use over many years. Its most common adverse effects are gastrointestinal in nature. However, the drug carries a rare but serious risk of lactic acidosis. Recognized risk factors for metformin-associated lactic acidosis (MALA) include renal or hepatic impairment, excessive alcohol consumption, poorly controlled diabetes, ketosis, prolonged fasting, and conditions predisposing to hypoxia. This paper presents a case of MALA in a 75-year-old patient with T2DM and schizophrenia who lacked any typical risk factors. This case underscores the importance of maintaining a high index of suspicion for this potentially fatal complication in all patients taking metformin. Early recognition and prompt intervention are critical to improving clinical outcomes.
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