Publication Name	World Journal of Diabetes
Manuscript ID	91199
Country	Singapore

Category	Critical Care Medicine
Manuscript Type	Minireviews
Article Title	Metformin-associated lactic acidosis: A mini review of pathophysiology, diagnosis and management in critically ill patients
Manuscript Source	Invited Manuscript
All Author List	Kay Choong See
Funding Agency and Grant Number
Corresponding Author	Kay Choong See, FCCP, FRCP, MBBS, MRCP, Adjunct Associate Professor, Department of Medicine, National University Hospital, Level 10, NUHS Tower Block, 1E Kent Ridge Road, Singapore 119228, Singapore. kaychoongsee@nus.edu.sg
Key Words	Acid-base equilibrium; Biguanides; Oxidative phosphorylation; Pyruvic acid; Renal replacement therapy
Core Tip	Metformin-associated lactic acidosis (MALA) in critically ill patients may be suspected in a patient who has received metformin and who has a high anion gap metabolic acidosis, and confirmed when lactate exceeds 5 mmol/L. Risk factors include those that reduce renal elimination of metformin and excessive alcohol consumption. Treatment of MALA involves immediate cessation of metformin, supportive management, treating other concurrent causes of lactic acidosis like sepsis, and treating any coexisting diabetic ketoacidosis. Severe MALA requires extracorporeal removal of metformin with either intermittent hemodialysis or continuous kidney replacement therapy.
Citation	See KC. Metformin-associated lactic acidosis: A mini review of pathophysiology, diagnosis and management in critically ill patients. World J Diabetes 2024; In press

Received	2023-12-24 12:59
Peer-Review Started	2023-12-24 12:59
To Make the First Decision
Return for Revision	2024-04-04 08:52
Revised	2024-04-04 13:43
Second Decision	2024-04-16 09:24
Accepted by Journal Editor-in-Chief
Accepted by Company Editor-in-Chief	2024-04-23 08:39
Articles in Press	2024-04-23 08:39
Publication Fee Transferred
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9358 (online)
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