Risk of lactic acidosis in type 2 diabetes patients using metformin: A case control study

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Resumé

Background Metformin constitutes first-line treatment of type 2 diabetes mellitus. It is presumed to have lactic acidosis as a dangerous, but rare, side effect. Objectives To estimate the incidence rate of lactic acidosis in patients with type 2 diabetes mellitus as well as to estimate the relative risk of lactic acidosis associated with metformin treatment. Methods This is a population-based combined cohort and case-control study among patients with type 2 diabetes mellitus who were acutely admitted with lactic acidosis at Odense University Hospital, Denmark; in the period from 1st June 2009 to 1st October 2013. The patients included as cases were all acutely hospitalized with lactic acidosis (pH <7.35 and lactate 2.0 mmol/l). For each case, we identified 24 age- and sex-matched controls sampled from the same cohort with type 2 diabetes mellitus. The use of metformin identified by using a prescription database. Analyses included multivariable logistic regression and adjusting for predefined confounding: renal function, HbA1c, comorbidity and diabetes duration. Results Our cohort included 10,652 patients with type 2 diabetes mellitus with a median age of 74 years, and 51.5% were male. During follow-up, 163 individuals were hospitalized with lactic acidosis, corresponding to an incidence rate of 391/100,000 person years. Use of metformin was not associated with lactic acidosis: adjusted odds ratio was 0.79 (95%CI 0.54–1.17)Conclusion Among patients with type 2 diabetes mellitus, the incidence rate of acute hospitalization with lactic acidosis was 391/100,000 person years. Use of metformin did not increase the risk of lactic acidosis. However, comorbidity seems to be an important risk factor.

OriginalsprogEngelsk
Artikelnummere0196122
TidsskriftPLOS ONE
Vol/bind13
Udgave nummer5
Antal sider13
ISSN1932-6203
DOI
StatusUdgivet - 2018

Fingeraftryk

metformin
Lactic Acidosis
Metformin
acidosis
Medical problems
case-control studies
noninsulin-dependent diabetes mellitus
Type 2 Diabetes Mellitus
Case-Control Studies
milk
incidence
Comorbidity
Incidence
Milk
glycohemoglobin
renal function
Denmark
relative risk
odds ratio
lactates

Citer dette

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title = "Risk of lactic acidosis in type 2 diabetes patients using metformin: A case control study",
abstract = "Background Metformin constitutes first-line treatment of type 2 diabetes mellitus. It is presumed to have lactic acidosis as a dangerous, but rare, side effect. Objectives To estimate the incidence rate of lactic acidosis in patients with type 2 diabetes mellitus as well as to estimate the relative risk of lactic acidosis associated with metformin treatment. Methods This is a population-based combined cohort and case-control study among patients with type 2 diabetes mellitus who were acutely admitted with lactic acidosis at Odense University Hospital, Denmark; in the period from 1st June 2009 to 1st October 2013. The patients included as cases were all acutely hospitalized with lactic acidosis (pH <7.35 and lactate 2.0 mmol/l). For each case, we identified 24 age- and sex-matched controls sampled from the same cohort with type 2 diabetes mellitus. The use of metformin identified by using a prescription database. Analyses included multivariable logistic regression and adjusting for predefined confounding: renal function, HbA1c, comorbidity and diabetes duration. Results Our cohort included 10,652 patients with type 2 diabetes mellitus with a median age of 74 years, and 51.5{\%} were male. During follow-up, 163 individuals were hospitalized with lactic acidosis, corresponding to an incidence rate of 391/100,000 person years. Use of metformin was not associated with lactic acidosis: adjusted odds ratio was 0.79 (95{\%}CI 0.54–1.17)Conclusion Among patients with type 2 diabetes mellitus, the incidence rate of acute hospitalization with lactic acidosis was 391/100,000 person years. Use of metformin did not increase the risk of lactic acidosis. However, comorbidity seems to be an important risk factor.",
keywords = "Acidosis, Lactic/chemically induced, Aged, Aged, 80 and over, Case-Control Studies, Comorbidity, Denmark/epidemiology, Diabetes Mellitus, Type 2/drug therapy, Drug-Related Side Effects and Adverse Reactions/etiology, Female, Humans, Hypoglycemic Agents/adverse effects, Incidence, Male, Metformin/adverse effects, Risk Factors",
author = "Abdellatif Aharaz and Anton Potteg{\aa}rd and Henriksen, {Daniel Pilsgaard} and Jesper Hallas and Henning Beck-Nielsen and Lassen, {Annmarie Touborg}",
year = "2018",
doi = "10.1371/journal.pone.0196122",
language = "English",
volume = "13",
journal = "P L o S One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "5",

}

Risk of lactic acidosis in type 2 diabetes patients using metformin : A case control study. / Aharaz, Abdellatif; Pottegård, Anton; Henriksen, Daniel Pilsgaard; Hallas, Jesper; Beck-Nielsen, Henning; Lassen, Annmarie Touborg.

I: PLOS ONE, Bind 13, Nr. 5, e0196122, 2018.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Risk of lactic acidosis in type 2 diabetes patients using metformin

T2 - A case control study

AU - Aharaz, Abdellatif

AU - Pottegård, Anton

AU - Henriksen, Daniel Pilsgaard

AU - Hallas, Jesper

AU - Beck-Nielsen, Henning

AU - Lassen, Annmarie Touborg

PY - 2018

Y1 - 2018

N2 - Background Metformin constitutes first-line treatment of type 2 diabetes mellitus. It is presumed to have lactic acidosis as a dangerous, but rare, side effect. Objectives To estimate the incidence rate of lactic acidosis in patients with type 2 diabetes mellitus as well as to estimate the relative risk of lactic acidosis associated with metformin treatment. Methods This is a population-based combined cohort and case-control study among patients with type 2 diabetes mellitus who were acutely admitted with lactic acidosis at Odense University Hospital, Denmark; in the period from 1st June 2009 to 1st October 2013. The patients included as cases were all acutely hospitalized with lactic acidosis (pH <7.35 and lactate 2.0 mmol/l). For each case, we identified 24 age- and sex-matched controls sampled from the same cohort with type 2 diabetes mellitus. The use of metformin identified by using a prescription database. Analyses included multivariable logistic regression and adjusting for predefined confounding: renal function, HbA1c, comorbidity and diabetes duration. Results Our cohort included 10,652 patients with type 2 diabetes mellitus with a median age of 74 years, and 51.5% were male. During follow-up, 163 individuals were hospitalized with lactic acidosis, corresponding to an incidence rate of 391/100,000 person years. Use of metformin was not associated with lactic acidosis: adjusted odds ratio was 0.79 (95%CI 0.54–1.17)Conclusion Among patients with type 2 diabetes mellitus, the incidence rate of acute hospitalization with lactic acidosis was 391/100,000 person years. Use of metformin did not increase the risk of lactic acidosis. However, comorbidity seems to be an important risk factor.

AB - Background Metformin constitutes first-line treatment of type 2 diabetes mellitus. It is presumed to have lactic acidosis as a dangerous, but rare, side effect. Objectives To estimate the incidence rate of lactic acidosis in patients with type 2 diabetes mellitus as well as to estimate the relative risk of lactic acidosis associated with metformin treatment. Methods This is a population-based combined cohort and case-control study among patients with type 2 diabetes mellitus who were acutely admitted with lactic acidosis at Odense University Hospital, Denmark; in the period from 1st June 2009 to 1st October 2013. The patients included as cases were all acutely hospitalized with lactic acidosis (pH <7.35 and lactate 2.0 mmol/l). For each case, we identified 24 age- and sex-matched controls sampled from the same cohort with type 2 diabetes mellitus. The use of metformin identified by using a prescription database. Analyses included multivariable logistic regression and adjusting for predefined confounding: renal function, HbA1c, comorbidity and diabetes duration. Results Our cohort included 10,652 patients with type 2 diabetes mellitus with a median age of 74 years, and 51.5% were male. During follow-up, 163 individuals were hospitalized with lactic acidosis, corresponding to an incidence rate of 391/100,000 person years. Use of metformin was not associated with lactic acidosis: adjusted odds ratio was 0.79 (95%CI 0.54–1.17)Conclusion Among patients with type 2 diabetes mellitus, the incidence rate of acute hospitalization with lactic acidosis was 391/100,000 person years. Use of metformin did not increase the risk of lactic acidosis. However, comorbidity seems to be an important risk factor.

KW - Acidosis, Lactic/chemically induced

KW - Aged

KW - Aged, 80 and over

KW - Case-Control Studies

KW - Comorbidity

KW - Denmark/epidemiology

KW - Diabetes Mellitus, Type 2/drug therapy

KW - Drug-Related Side Effects and Adverse Reactions/etiology

KW - Female

KW - Humans

KW - Hypoglycemic Agents/adverse effects

KW - Incidence

KW - Male

KW - Metformin/adverse effects

KW - Risk Factors

U2 - 10.1371/journal.pone.0196122

DO - 10.1371/journal.pone.0196122

M3 - Journal article

C2 - 29738540

AN - SCOPUS:85046664222

VL - 13

JO - P L o S One

JF - P L o S One

SN - 1932-6203

IS - 5

M1 - e0196122

ER -