BACKGROUND: Metformin is considered a first choice for oral treatment of patients with type 2 diabetes in the absence of contraindications. Colorectal cancer is the second most frequent cancer among the general population; low anterior resections and temporary diverting ileostomies are commonly performed in this population. As the incidence of type 2 diabetes increases, the use of metformin in patients with both type 2 diabetes and an ileostomy will most likely increase as well. CASE: We present the case of a patient affected by colorectal cancer who developed a severe metformin-associated lactic acidosis (MALA) after creation of a temporary ileostomy to protect a low colorectal anastomosis. High-volume output from his ileostomy led to significant fluid loss and electrolyte imbalance, his condition was complicated by MALA, resulting in death. CONCLUSION: The population of ileostomy patients who also have type 2 diabetic and taking metformin is at risk for MALA. High stomal output can lead to dehydration, with a loss of fluids and electrolytes and metformin could aggravate this condition, potentiating the risk of MALA.

Tirelli, F., Biondi, A., Persiani, R., Fatal case of metformin-associated lactic acidosis associated with temporary ileostomy: A case report, <<JOURNAL OF WOUND OSTOMY AND CONTINENCE NURSING>>, 2020; 45 (4): 364-365. [doi:10.1097/WON.0000000000000447] [http://hdl.handle.net/10807/173129]

Fatal case of metformin-associated lactic acidosis associated with temporary ileostomy: A case report

Tirelli, Flavio;Biondi, Alberto;Persiani, Roberto
2018

Abstract

BACKGROUND: Metformin is considered a first choice for oral treatment of patients with type 2 diabetes in the absence of contraindications. Colorectal cancer is the second most frequent cancer among the general population; low anterior resections and temporary diverting ileostomies are commonly performed in this population. As the incidence of type 2 diabetes increases, the use of metformin in patients with both type 2 diabetes and an ileostomy will most likely increase as well. CASE: We present the case of a patient affected by colorectal cancer who developed a severe metformin-associated lactic acidosis (MALA) after creation of a temporary ileostomy to protect a low colorectal anastomosis. High-volume output from his ileostomy led to significant fluid loss and electrolyte imbalance, his condition was complicated by MALA, resulting in death. CONCLUSION: The population of ileostomy patients who also have type 2 diabetic and taking metformin is at risk for MALA. High stomal output can lead to dehydration, with a loss of fluids and electrolytes and metformin could aggravate this condition, potentiating the risk of MALA.
2018
Inglese
Tirelli, F., Biondi, A., Persiani, R., Fatal case of metformin-associated lactic acidosis associated with temporary ileostomy: A case report, <<JOURNAL OF WOUND OSTOMY AND CONTINENCE NURSING>>, 2020; 45 (4): 364-365. [doi:10.1097/WON.0000000000000447] [http://hdl.handle.net/10807/173129]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/173129
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