Metformin-associated lactic acidosis : myth or reality ?
Abstract
Metformin is the first line therapy for patients with diabete type 2. However, the molecule is known to be responsible for lactic acidosis through its inhibition of the mitochondrial respiratory chain complex, a pathology called MALA (metformin associated lactic acidosis). This complication has been widely discussed in the literature because its development is usually the result of a multifactorial and complex process. As the mortality of MALA is potentially high, a good knowledge of the physiopathology, existing treatments and predisposing factors is necessary for the primary care physician.
La metformine est le médicament de première ligne pour le traitement du diabète de type 2. Cependant, par un mécanisme d’inhibition de la respiration mitochondriale encore mal connu, la molécule pourrait favoriser le développement d’une acidose lactique, pathologie appelée MALA (metformin-associated lactic acidosis). Décrite depuis de nombreuses années, cette complication est largement débattue dans la littérature car sa formation résulte d’un processus multifactoriel et complexe. Il est essentiel pour les praticiens de connaître la physiopathologie, les facteurs prédisposants et les traitements de la MALA, car cette pathologie est potentiellement mortelle.
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