METFORMIN-INDUCED LACTIC ACIDOSIS (MALA): A CASE REPORT

Background: Metformin is a first-line oral hypoglycemic agent widely used in type 2 diabetes mellitus.
Although generally safe, it can rarely cause metformin-induced lactic acidosis (MALA), a serious and
potentially fatal complication, particularly in patients with renal impairment. Case Presentation: A 62-year-old male with a history of type 2 diabetes mellitus and chronic kidney disease presented with altered sensorium, breathlessness, and generalized weakness. Laboratory investigations revealed severe metabolic acidosis (pH 7.08), elevated serum lactate (12.5 mmol/L), and impaired renal function (serum creatinine 3.2 mg/dL). A detailed medication history revealed long-term metformin use. Other causes of lactic acidosis were excluded, leading to a diagnosis of MALA. Management and Outcome: The patient was managed with immediate discontinuation of metformin, supportive
care, and hemodialysis, resulting in normalization of metabolic parameters and clinical recovery.
Conclusion: Early recognition and prompt intervention are crucial in reducing morbidity and mortality
associated with MALA