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Master Thesis

Acidose lactique à la metformine

Abstract : Introduction: Lactic acidosis is a rare but serious complication of metformin, and fatal to 50% of cases. The prevalence of type two diabetes is 8.8%, double that of metropolitan France. The general practitioner, pivot support diabetes should be able to identify transient or permanent contre-indications and its factors of decompensation. This study aims to identify patients with type two treated with metformin, admitted to the emergency department with a clinical picture that required to do arterial blood gases recovering lactic acidosis, comparing the group of MALA or non-MALA and compare mortality obtained the publications. Materials and Methods: A descriptive study and a prospective cohort care in the emergency department of St. PIERRE, from 1 June 2013 to 31 May 2014. The plasma metforminémie was measured in all patients. Results: 25 patients were included. 15 of these patients had an overdose of metformin. After sensibility of practitioners, we had no deaths. The dosage of metforminémie, the consultation period, vomiting and hyperkalemia appear to be factors associated with MALA, unlike alcohol, the presence of a diuresis and hypothermia. Conclusion: The absence of mortality, despite the presence of prognostic factors, when metformin lactic acidosis can be prevented by increased advice of the first lines of doctors, or the attending physician and the emergency physician. This starts with respect for contre-indications, regular assessment of treatment and increased prevention through information to the patient.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01153736
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Submitted on : Wednesday, May 20, 2015 - 1:55:37 PM
Last modification on : Wednesday, August 23, 2017 - 4:31:21 PM
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Laïla Zitouni. Acidose lactique à la metformine. Médecine humaine et pathologie. 2014. ⟨dumas-01153736⟩

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