Abstract
A fatal case of phenformin-induced lactic acidosis in a patient with “late onset” diabetes mellitus is presented. The typical clinical and biochemical features of coma, hypothermia, hypotension, acidosis, hypoglycæmia, mild ketonuria, moderate azotæmia and a large anion gap are demonstrated. Any degree of azotæmia is a contraindication to the use of phenformin, since fatalities have been recorded only in this setting.
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