Lactic acidosis rates in type 2 diabetes
Lactic acidosis rates in type 2 diabetes
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DOI：
10.2337/diacare.21.10.1659
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发表时间：
1998-10-01
期刊：
影响因子：
16.2
通讯作者：
Latare, P
中科院分区：
文献类型：
--
作者：
Brown, JB;Pedula, K;Latare, P
目的-为了提供一个背景下使用二甲双胍患者的乳酸酸中毒风险的解释，我们测量了二甲双胍在美国被批准使用之前2型糖尿病患者的乳酸酸中毒率。研究设计和方法-使用由大型非营利健康维护组织（HMO）维护的出院诊断和实验室结果的电子数据库，我们在三个地理和种族不同的2型糖尿病人群中确定了可能的乳酸酸中毒事件。然后，我们回顾了硬拷贝临床记录，以确认和描述每一个事件，并确定其可能的causes.RESULTS -从> 41，000人-年的经验，我们发现4个确认，3个可能，和3个临界的乳酸酸中毒病例。在每一个病例中，我们都确定了至少一种可能导致酸中毒的严重疾病。每年确认的事件发生率与二甲双胍相关的乳酸酸中毒的公布率相似。结论-乳酸酸中毒经常发生，虽然不常见，在2型糖尿病患者中，其发生率与二甲双胍使用者相似。二甲双胍相关和自然发生的乳酸酸中毒同时发生的医学状况也是其潜在原因。观察到的二甲双胍和乳酸酸中毒之间的相关性可能是巧合，而不是因果关系。这种可能性值得进一步研究。
OBJECTIVE - To provide a context for the interpretation of lactic acidosis risk among patients using metformin, we measured rates of lactic acidosis in patients with type 2 diabetes before metformin was approved for use in the U.S.RESEARCH DESIGN AND METHODS - Using electronic databases of hospital discharge diagnoses and laboratory results maintained by a large, nonprofit health maintenance organization (HMO), we identified possible lactic acidosis events in three geographically and racially diverse populations with type 2 diabetes. We then reviewed hard-copy clinical records to confirm and describe each event and determine its likely cause(s).RESULTS - From >41,000 person-years of experience, we found four confirmed, three possible, and three borderline cases of lactic acidosis. In each case, we identified at least one severe medical condition that could have caused the acidosis. The annual confirmed event rate is similar to published rates of metformin-associated lactic acidosis.CONCLUSIONS - Lactic acidosis occurs regularly, although infrequently, among persons with type 2 diabetes, at rates similar to its occurrence among metformin users. The medical conditions with which both metformin-associated and naturally occurring lactic acidosis co-occur are also its potential causes. The observed association between metformin and lactic acidosis may be coincidental rather than causal. This possibility merits further study.