Volume : 13, Issue : 04, April – 2026
Title:
METFORMIN-INDUCED LACTIC ACIDOSIS (MALA): A CASE REPORT
Authors :
Mirudula.S, Kavya.M, Gokulakrishnan.D, Shajithkhan.S, Dr. Immanuel Jebastine
Abstract :
Background: Metformin is a first-line oral hypoglycemic agent widely used in type 2 diabetes mellitus. Although generally safe, it can rarely cause metformin-induced lactic acidosis (MALA), a serious and potentially fatal complication, particularly in patients with renal impairment.
Case Presentation: A 62-year-old male with a history of type 2 diabetes mellitus and chronic kidney disease presented with altered sensorium, breathlessness, and generalized weakness. Laboratory investigations revealed severe metabolic acidosis (pH 7.08), elevated serum lactate (12.5 mmol/L), and impaired renal function (serum creatinine 3.2 mg/dL). A detailed medication history revealed long-term metformin use. Other causes of lactic acidosis were excluded, leading to a diagnosis of MALA.
Management and Outcome: The patient was managed with immediate discontinuation of metformin, supportive care, and hemodialysis, resulting in normalization of metabolic parameters and clinical recovery.
Conclusion: Early recognition and prompt intervention are crucial in reducing morbidity and mortality associated with MALA.
Keywords: Metformin, Lactic Acidosis, Type 2 Diabetes Mellitus, Renal Failure, Adverse Drug Reaction
Cite This Article:
Please cite this article in press Immanuel Jebastine et al., Metformin-induced lactic acidosis (MALA): A case report, Indo Am. J. P. Sci, 2026; 13(04).
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