Acute Metformin Overdose: Examining Serum pH, Lactate Level, and Metformin Concentrations in Survivors Versus Nonsurvivors: A Systematic Review of the Literature

A Fatal Case of Metformin-associated Lactic Acidosis

“…In the present case, the peak serum metformin level was 432 mg/L. To our knowledge, this is one of the highest reported levels, with the highest level being 749 mg/ L in a case reported by Sánchez-Rubio Ferrandez et al (9,12,13,14).…”

Intoxication volontaire fatale à la metformine

“…La concentration de metformine ne semble pas non plus strictement corrélée à la survenue et à l'importance de l'acidose lactique. Plusieurs publications, de patients décédés ou survivants, témoignent d'une possible corrélation entre DSI, gravité de l'acidose et mortalité [5]. Celle-ci est dépendante de la prise en charge : épuration digestive, épuration extra-rénale précoce… Dans le cas rapporté, la concentration importante de metformine va dans le sens de son implication très probable dans le tableau clinique présenté par la patiente et son évolution fatale.…”

Fatal Metformin Intoxication with Markedly Elevated Blood and Liver Concentrations

“…Fatal overdoses associated with metformin have been extensively described (10,11). Treatments including gastrointestinal decontamination, sodium bicarbonate therapy and extracorporeal elimination have been employed with mixed results (10,12); however, some authors suggest that the risk of mortality may depend more on the degree of metabolic acidosis that develops in conjunction with elevated serum lactate and metformin concentrations (13).…”