Lactic Acidosis and Prior Metformin Treatment

Prognosis of Lactic Acidosis Upon Admission to Intensive Care According to the Existence of Prior Treatment With Metformin

Status

Recruiting

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT07300293

Acronym

MALA

Enrollment

100

Registered

2025-12-23

Start date

2024-11-06

Completion date

2026-05-31

Last updated

2025-12-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Type 2 Diabetes

Keywords

Type 2 diabetes, Metformin Treatment, Lactic acidosis, Metabolic acidosis

Brief summary

Metformin is a drug frequently prescribed to patients with type 2 diabetes. Furthermore, diabetes can lead to micro- and macrovascular complications that may cause chronic organ failure. The presence of diabetes also increases the risk of infections. All of these factors contribute to the frequent admission of patients to the ICU who have been receiving metformin treatment in the preceding days. Acute renal failure, which is also frequently observed upon admission to the ICU, increases the risk of metformin overdose. In cases of overdose, metformin acts on several metabolic pathways that can lead to or even accelerate metabolic acidosis, sometimes severe. However, the impact on prognosis is controversial. The role of metformin in lactic acidosis in patients treated for acute illness may be underestimated in routine practice. This study aims to investigate the impact of prior metformin treatment on ICU survival in patients admitted to the ICU with severe lactic acidosis.

Interventions

None listed

Study design

Observational model

CASE_CONTROL

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Inclusion criteria

* Adult patient (≥18 years) * Admitted to the intensive care unit of Hautepierre Hospital - Strasbourg University Hospital between January 1, 2014, and December 31, 2023 * Having experienced lactic acidosis (pH \<7.35 and lactate level ≥5 mmol/L) within the first 24 hours of hospitalization.

Exclusion criteria

* Patient without arterial blood gas measurements during the first 24 hours of admission * whose background treatment is unknown and could not be determined * for whom a limitation of active therapies was implemented before or during the first 24 hours of hospitalization

Design outcomes

Primary

Measure	Time frame
Survival rates of patients with severe lactic acidosis admitted to the ICU after prior metformin treatment	Up to 18 months

Countries

France

Contacts

Primary ContactVincent CASTELAIN, MD, PhD

vincent.castelain@chru-strasbourg.fr33 3.88.12.79.15

Outcome results