Metformin-induced Lactic Acidosis in Type 2 Diabetes Mellitus Patient with Chronic Renal Failure Presenting with Altered Consciousness

Metformin is a widely used oral-antidiabetic with positive effects on metabolism. Its effect on carbohydrate metabolism, lipid profile, weight balance and low price makes it the common choice of treatment in developing countries. Although chronic conditions such as chronic renal failure necessitating hemodialysis are contra-indicated for metformin use, current data shows that, when compared to other oral-atidiabetics, metformin is not associated with an increased risk of lactic acidosis. We describe a patient on metformin therapy with hemodialysis treatment for end stage renal disease, presenting to the emergency department with altered mental status. Metformin-induced lactic acidosis was diagnosed and he was treated with hemodialysis.