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Journal of Diabetes Research
Volume 2016, Article ID 3545914, 8 pages
http://dx.doi.org/10.1155/2016/3545914
Research Article

Lactic Acidosis in Diabetic Population: Is Metformin Implicated? Results of a Matched Case-Control Study Performed on the Type 2 Diabetes Population of Grenoble Hospital University

1Centre Régional de Pharmacovigilance, Pôle Santé Publique, Centre Hospitalier Universitaire de Grenoble, 38000 Grenoble, France
2Service de Biostatistique des Hospices Civils de Lyon, 69002 Lyon, France
3Laboratoire Biostatistique Santé, UCBL, Equipe de l’UMR CNRS 5558, 69495 Pierre-Bénite Cedex, France
4Pôle Pharmacie, Centre Hospitalier Universitaire de Grenoble, 38000 Grenoble, France
5Université Grenoble Alpes, 38000 Grenoble, France

Received 10 December 2015; Revised 15 January 2016; Accepted 8 February 2016

Academic Editor: Mitsuhiko Noda

Copyright © 2016 Marion Lepelley et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. To evaluate the strength of association between lactic acidosis (LA) and well-recognized risk factors for LA, particularly the weight of metformin. Methods. This study is a matched case-control analysis concerning the type 2 diabetes population from Grenoble Hospital University. Cases of LA were defined biologically with pH < 7.35 and lactates > 5 mmol/L. They were matched to 2 controls defined as type 2 diabetic inpatients who did not present a LA during the study period. We performed a conditional logistic regression. Results. We included 302 cases and 604 controls; mean age was 69.5 years (SD 11.93). Intercurrent diseases were significantly associated with LA. Chronic medical conditions had a minor impact on LA incidence, except hepatocellular dysfunction. Metformin was significantly associated with a higher LA probability in case of acute kidney injury (AKI) (OR = 1.79; value = 0.020) but not in patients without AKI. Discussion and Conclusions. According to this study, metformin, compared to acute medical conditions, seemed not to be associated with LA in patients with type 2 diabetes; however in case of AKI, metformin may be associated with LA.