Doctors found a way to stop a deadly metformin reaction

"Metformin-associated lactic acidosis (MALA) is an uncommon but potentially life-threatening complication linked to the diabetes medication metformin. The condition occurs when excessive lactic acid builds up in the body, leading to dangerous changes in blood chemistry. Researchers developed and evaluated a clinical protocol aimed at improving how MALA is recognized and treated. Their findings were presented at ASN Kidney Week 2025."

"The protocol emphasized the immediate start of dialysis as soon as MALA was identified, using one of three methods: intermittent hemodialysis, continuous kidney replacement therapy, or peritoneal dialysis. The program was introduced at Maharat Nakhonratchasima Hospital (MNRH) in Thailand, while Burirum Hospital (BH) served as a comparison site and continued standard care without the new approach. Over a five-year study period, the researchers analyzed 347 total cases (70 at MNRH before the protocol, 129 after the protocol, and 148 at BH)."

"Major Reductions in Deaths and Faster Treatment Results showed striking improvements at Maharat Nakhonratchasima Hospital. The 30-day death rate fell from 25.7% before the new system to 13.9% afterward. At Burirum Hospital, which did not adopt the protocol, mortality rates remained unchanged (27.2% and 30%). The ongoing data at MNRH showed a steady decline in deaths,"

A hospital in Thailand implemented a protocol prioritizing immediate dialysis for metformin-associated lactic acidosis (MALA), using intermittent hemodialysis, continuous kidney replacement therapy, or peritoneal dialysis. A second regional hospital continued standard care as a comparison. Over five years, 347 total MALA cases were recorded: 70 at the implementing hospital before the protocol, 129 after implementation, and 148 at the comparison hospital. At the implementing hospital, 30-day mortality decreased from 25.7% to 13.9% after protocol adoption, while mortality at the comparison hospital remained essentially unchanged (27.2% and 30%). Treatment initiation times shortened and clinical awareness increased.

Read at ScienceDaily