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Does high-dose metformin cause lactic acidosis in type 2 diabetic patients after CABG surgery? A double blind randomized clinical trial

Baradari, A.G. and Habibi, M.R. and Khezri, H.D. and Aarabi, M. and Khademloo, M. and Jalali, Z. and Ghafari, R. (2011) Does high-dose metformin cause lactic acidosis in type 2 diabetic patients after CABG surgery? A double blind randomized clinical trial. Heart International, 6 (1). pp. 26-30. ISSN 18261868 (ISSN)

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Abstract

Metformin is a dimethyl biguanide oral anti-hyperglycemic agent. Lactic acidosis due to metformin is a fatal metabolic condition that limits its use in patients in poor clinical condition, consequently reducing the number of patients who benefit from this medication. In a double blind randomized clinical trial, we investigated 200 type 2 diabetic patients after coronary artery bypass surgery in the open heart ICU of the Mazandaran Heart Center, and randomly assigned them to equal intervention and control groups. The intervention group received regular insulin infusion along with 2 metformin 500 mg tablets every twelve hours, while the control group received only intravenous insulin with 2 placebo tablets every twelve hours. Lactate level, pH, base excess, blood glucose and serum creatinine were measured over five 12 h periods, with data averaged for each period. The primary outcome in this study was high lactate levels. Comparison between the 2 groups was made by independent Student's t-test. To compare changes in multiple measures in each group and analysis of group interaction, a repeated measurement ANOVA test was used. There was no significant difference between the 2 groups regarding pH, base excess, or bicarbonate intake (P>0.05). No patient showed lactic acidosis in either group. Lactate levels were 23.0 vs 23.4 in the insulin-metformin and insulin only groups when the study was started, respectively. At the end of the study, those levels were 18.7 vs 18.9, respectively. In addition, the ANOVA repeated measurement test did not show a significant difference in terms of changes in the amount of lactate level between the 2 groups during the five measurement tests of the study period (P>0.05). High-dose metformin (1,000 mg twice daily with insulin) does not cause lactic acidosis in type 2 diabetic patients after coronary artery bypass surgery. © A.G. Baradari et al., 2011.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Heart Int. [Field not mapped to EPrints] AD - Department of CardicAnestesia, Mazandaran University of Medical Sciences, Sari, Iran [Field not mapped to EPrints] AD - Faculty of Nursing and Midwif y, Mazandaran University of Medical Sciences, Sari, Iran [Field not mapped to EPrints] AD - Cardiovascular Research Center, Golestan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] AD - Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran [Field not mapped to EPrints] AD - Department of Cardiac Surgery, Mazandaran University of Medical Sciences, Sari, Iran [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: Coronary artery bypass, Lactic acidosis, Metformin, Type 2 diabetes, insulin, metformin, placebo, adult, aged, alkalosis, article, blood sampling, controlled study, coronary artery bypass surgery, double blind procedure, drug megadose, glucose blood level, human, lactate blood level, lactic acidosis, major clinical study, non insulin dependent diabetes mellitus, pH, randomized controlled trial, side effect, treatment outcome
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 18 Apr 2015 04:39
Last Modified: 13 May 2015 10:16
URI: http://eprints.goums.ac.ir/id/eprint/2093

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