Citation

Iwai H, Ohno Y, Itoh H, Endo T, Komaki K, Ishii S, Morioka Y, Imonawa H, Kiyokawa T, Harada T, Hirota N, Yamauchi T, Miyatake T, Aoki N. Journal of the Japan Diabetes Society 2004; 47(6): 439-445.

Copyright

(Copyright © 2004)

DOI

unavailable

PMID

unavailable

Abstract

A 38-year-old man treated with oral metformin and insulin injection for type 2 diabetes mellitus since 5 years ago attempted on April 5, 2003, to kill himself by overdosing on metformin (26.25 g) and was seen for nausea, vomiting, epigastralgia, and disturbance of consciousness. He was diagnosed with lactic acidosis and acute renal failure based on findings of elevated serum lactic acid (178.9 mg/dl), urea nitrogen (BUN) (128 mg/dl), and creatinine (11.8 mg/dl), and metabolic acidosis with a wide anion gap(anion gap 58.8, pH 7.219). Lactic acidosis and acute renal failure were improved by continuous hemodialysis filtration (CHDF) and intravenous fluid therapy. Diabetic control was improved by insulin therapy. After that, the patient was discharged. CHDF is recommended to treat metformin-induced lactic acidosis to maintain blood circulation.

Language: ja

Keywords

adult; human; suicide; male; case report; hemodialysis; drug overdose; article; clinical feature; acute kidney failure; insulin; creatinine blood level; non insulin dependent diabetes mellitus; metabolic acidosis; lactic acidosis; metformin; insulin treatment; lactate blood level; urea nitrogen blood level