| DOI: 10.29090/psa.2026.02.25.6213 | Pharm Sci Asia 2026; 53(2), 203-210 |
Risk factors associated with metformin associated lactic acidosis (MALA) in type 2 diabetic patients receiving metforminPemmarin Potisarach1, Juntip Kanjanasilp2, Nayrata Pinnetdharn3, Sansanee Wangvoralak3, Siraprapa Sonsri4, Thitima Srimarueang4, Krongkan Sawamichai5, Phongsathorn Tanawsri5, Sirawan Tonja5, Natedow Khamsita5, Pattarin Kittiboonyakun2*
1 International Primary Care Practice Research Unit (iPCPRU), Faculty of Pharmacy, Mahasarakham University, Kham-Riang Subdistrict, Kantharawichai District, Maha Sarakham Province, Thailand
2
Health Services and Pharmacy Practice Research and Innovation (HSPRI), Faculty of Pharmacy, Mahasarakham University, Kham-Riang Subdistrict, Kantharawichai District, Maha Sarakham Province, Thailand
3
Department of Fishery Management, Faculty of Fisheries, Kasetsart University Bangkok, Thailand
4
Clinical Pharmacy Service Division, Surin Hospital, Muang District, Surin Province, Thailand
5
Faculty of Pharmacy, Mahasarakham University, Kham-Riang Subdistrict, Kantharawichai District, Maha Sarakham Province, Thailand
Metformin-associated lactic acidosis (MALA) is a rare but potentially fatal condition characterized by bloodstream lactic acid levels exceeding 5.0 mmol/L, leading to acidemia (blood pH less than 7.35), with mortality rates reaching up to 50% if not promptly and appropriately managed. However, there is limited evidence regarding the risk factors associated with the occurrence of MALA in diabetic patients receiving metformin within the Thai context. The aim of research was to investigate factors associated with MALA in type 2 diabetic patients taking metformin. A retrospective matched case-control study was conducted in a total of 272 type 2 diabetic patients. Data were collected from Surin Hospital’s electronic medical records from 2017 to 2021. Descriptive statistics and Chi-square tests were used. Binary logistic regression analysis with Backward Likelihood ratio (LR) selection method was used to determine the optimal final model of the predictor of MALA occurrence, at significance level of 0.01. During the 5-year period, 58,206 patients received treatment with metformin and only 136 cases were diagnosed with MALA. The majority of participants were female (56.6%) and had an average age of 60 years. It was shown that history of using combined pain relief medications had a 38.29-fold higher likelihood of developing MALA compared to those who did not use this medication (OR = 38.29, 99% CI 5.96-245.87). This study highlighted the importance of implementing comprehensive monitoring system for diabetic patients, with consideration of identified risk factors. Such an approach can help reduce the risk of MALA and enhance patient safety and outcomes.
Keyword:
Metformin associated lactic acidosis; MALA; Risk factors; Metformin
Download full paper (PDF File size: 474.74 KB.)
|
