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The doctors in the Renal-Electrolyte Division, Department of Medicine at UPMC discuss the findings from the research of the drug Metformin, for people with newly diagnosed type 2 diabetes melitus (DM). While this drug is a powerful tool  in the treatment of DM, it can also cause a risk of potentially fatal lactic acidosis.

Educational objectives:

Upon completion of this activity, participants should be able to:

  • Improve management of severe lactic acidosis through recognition of its association with metformin exposure
  • Improve patient outcomes by learning the role of dialysis in the treatment of metformin-associated lactic acidosis
  • Improve the management of diabetes using metformin in patients with decreased renal function

Reading Resources:

  1. Calello DP, Liu KD, Wiegand TJ, et al. Extracorporeal Treatment for Metformin Poisoning: Systematic Review and Recommendations From the Extracorporeal Treatments in Poisoning Workgroup. Crit Care Med 2015; 43(8): 1716-30
  2. Eppenga WL, Lalmohamed A, Geerts AF, et al. Risk of lactic acidosis or elevated lactate concentrations in metformin users with renal impairment: a population-based cohort study. Diabetes Care 2014; 37(8): 2218-24
  3. Kraut JA, Madias NE. Lactic acidosis. N Engl J Med 2014; 371(24): 2309-19.


Dr. Shamir has reported no relevant relationships with any entities producing health care goods or services.

Dr. Kaldas has reported no relevant relationships with any entities producing health care goods or services.

Dr. Tan has reported no relevant relationships with any entities producing health care goods or services.

All presenters disclosure of relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above.  No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of .5 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.05) continuing education units (CEU) which are equivalent to .5 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 10/12/2016 | Last Modified On: 10/12/2016 | Expires: 10/12/2017

This course has been expired.