• Internal medicine · Jan 2017

    Case Reports

    The Dramatic Recovery of a Patient with Biguanide-associated Severe Lactic Acidosis Following Thiamine Supplementation.

    • Shigeo Godo, Yoshitaro Yoshida, Motoo Fujita, Daisuke Kudo, Ryosuke Nomura, Hiroaki Shimokawa, and Shigeki Kushimoto.
    • Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan.
    • Intern. Med. 2017 Jan 1; 56 (4): 455-459.

    AbstractBiguanides are a drug of choice for the treatment of type 2 diabetes mellitus. Although they can cause lactic acidosis in susceptible patients with predisposing risk factors, the incidence of lactic acidosis is reported to be very low when they are used properly. We herein present a case of biguanide-associated severe lactic acidosis complicated with thiamine deficiency that was provoked without predisposing factors for thiamine deficiency. Diabetic patients taking biguanide may be predisposed to thiamine deficiency, even when there is no evidence of risk factors, and the high-dose administration of thiamine may be essential in the treatment of this otherwise under-recognized disorder.

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