Type 2 Diabetes Mellitus with Lactic Acidosis and Acute Renal Failure Induced by Metformin Overdose in Suicide

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  • Iwai Hiroshi
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Ohno Yasuhiro
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Itoh Hiroyuki
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Endo Tatsuji
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Komaki Katsumori
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Ishii Shuji
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Morioka Yukie
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Imonawa Hiroshi
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Kiyokawa Tomomi
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Harada Takeshi
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Hirota Noriyuki
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Yamauchi Takaaki
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Miyatake Toshiyuki
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine
  • Aoki Norihiko
    Department of Endocrinology, Metabolism, and Diabetes, Kinki University School of Medicine

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Other Title
  • 自殺目的でメトホルミンの多量内服後に乳酸アシドーシスと急性腎不全を発症した２型糖尿病の１例
  • ショウレイ ホウコク ジサツ モクテキ デ メトホルミン ノ タリョウ ナイフク ゴ ニ ニュウサン アシドーシス ト キュウセイ ジンフゼン オ ハッショウ シタ 2ガタ トウニョウビョウ ノ 1レイ

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A 38-year-old man treated with oral metformin and insulin injection for type 2 diabetes mellitus since 5 years ago attempted on April 5, 2003, to kill himself by overdosing on metformin (26.25g) and was seen for nausea, vomiting, epigastralgia, and disturbance of consciousness.He was diagnosed with lactic acidosis and acute renal failure based on findings of elevated serum lactic acid (178.9 mg/dl), urea nitrogen (BUN)(128 mg/dl), and creatinine (11.8 mg/dl), and metabolic acidosis with a wide anion gap (anion gap 58.8, pH 7.219).Lactic acidosis and acute renal failure were improved by continuous hemodialysis filtration (CHDF) and intravenous fluid therapy.Diabetic control was improved by insulin therapy.After that, the patient was discharged.CHDF is recommended to treat metformin-induced lactic acidosis to maintain blood circulation.

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