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At least 1,045 records · Page 58Linked to original sources
PubMed1981

[Lactic acidosis associated with fenformin therapy].

Irreversible lactic acidosis occurred in two phenformin-treated diabetics. In the first case, blood creatinine was 3 mg % ml, arterial blood pH was 7,12 and ketostix was negative; in the second case, blood creatinine was 1,3 mg% ml, arterial blood pH was 7,22 and ketostix was negative. Diabetic patients to be treated with phenformin must always be carefully selected and this treatment should be reserved for cases where there is a precise indication. Lactic acidosis may occur even in the presence of almost normal serum creatinine concentrations.

Acidosis↗
PubMed2001

Prevalence of A-to-G mutation at nucleotide 3243 of the mitochondrial tRNA(Leu(UUR)) gene in Japanese patients with diabetes mellitus and end stage renal disease.

The A-to-G mutation at nucleotide 3243 of the mitochondrial tRNA(Leu(UUR)) gene (mt.3243A>G) is associated with both diabetes mellitus and myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). Recently, this mutation was found in three diabetic subjects with progressive kidney disease, suggesting that it may be a contributing factor in the development of kidney disease in patients with diabetes. The aim of this study was to evaluate the contribution of this mutation to the development of end stage renal disease (ESRD) in patients with diabetes. The study group consisted of 135 patients with diabetes and ESRD. The control group consisted of 92 non-diabetic subjects with ESRD who were receiving hemodialysis. The mt.3243A>G mutation was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). We found the mt.3243A>G mutation in eight patients (8/135; 5.9%), all of whom were initially diagnosed with type II diabetes. Five of the eight patients were subsequently also diagnosed with MELAS. We did not find the mutation in any of the 92 nondiabetic subjects with ESRD. The prevalence of this mutation was 6.5-fold higher in patients with diabetes and ESRD than in those with diabetes alone (8/135 vs 5/550, respectively; chi2 = 13.704; P = 0.0002). The mt.3243A>G mutation may be a contributing genetic factor in the development of ESRD in Japanese patients with diabetes.

Adult↗
PubMed1990

[Lactic acidosis as a complication of treatment with biguanides].

In the course of two and a half years we treated six diabetic women on account of lactate acidosis during concurrent biguanide administration. The patients were given an average dose of 290 mg Buformin/24 hours. Their mean age was 71 years. Three patients died, i.e. the mortality was 50%. All patients reported nausea, vomiting and abdominal pain. Two suffered from diarrhoea. Two patients suffered from renal failure and one from cardiac weakness. One patient was in coma. The mean lactate concentration was 14.7 mmol/l, pH on admission was 6.84. The patients were given on average 550 mmol bicarbonate. In two instances bicarbonate dialysis was used. The authors discuss the pathophysiology, clinical aspects and importance for treatment and prevention of lactate acidosis during biguanide treatment.

Acidosis, Lactic↗
PubMed1985

Incidence of severe sideeffects during therapy with sulfonylureas and biguanides.

The most important side-effect of sulfonylureas is hypoglycaemia. According to surveys in Switzerland and in Sweden it occurs at a frequency of about 2 cases per 10,000 treatment years. Mortality is high, about 10%. The syndrome of inappropriate ADH-secretion has been observed almost exclusively during treatment with chlorpropamide. Asymptomatic cases of SIADH-syndrome are quite frequent, hyponatraemia has been observed in 6-10% of diabetics treated with chlorpropamide. The most dangerous side-effect of biguanides is lactic acidosis. It occurs significantly more frequent during treatment with phenformin compared to metformin. Metformin has been reported to lead to lactic acidosis in 0.4 cases per 10,000 treatment years; mortality is about 30%. Mortality of phenformin-associated lactic acidosis is even higher, 70%. Both biguanides, phenformin and metformin, cause relatively frequently vitamin B12-malabsorption (in about 1/3 of the cases). However, symptomatic vitamin B12-deficiency is extremely rare.

Acidosis↗
PubMed1972

Lactic acidosis with phenformin therapy.

Nine cases of severe acidosis occurring in patients with maturity onset diabetes who were receiving phenformin therapy were reviewed. All had evidence of renal disease. Lactic acidosis was diagnosed by elevated blood lactate levels in seven patients, and by the clinical manifestations and laboratory information in the other two. Contributing factors are discussed, as well as means of treatment and prevention. Although the specific etiology of renal disease is not emphasized in this paper, unrecognized progressive deterioration of renal function is implicated in the etiology of lactic acidosis.

Aged↗