Abstract
Metformin is a biguanide oral antihyperglycemic agent used to treat patients with non-insulin dependent diabetes mellitus (NIDDM). This medication is considered safe if not used in the presence of contraindications such as renal failure, liver disease, alcohol abuse, or congestive heart failure. The most significant adverse effect of metformin therapy is the development of lactic acidosis in the susceptible patients. We report a 62-year-old female with NIDDM and end stage renal disease on maintenance hemodialysis but metformin therapy was continued so life-threatening metformin-associated lactic acidosis (MALA) developed. Metformin is an effective and safe oral antihyperglycemic agent useful in the treatment of NIDDM but metformin use should be avoided in patients who have known contraindications to the agent.
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