Abstract：
Metformin is the preferred medication for the initial management of type 2 diabetes mellitus (T2DM). Although its use is widely recommended, caution should be exercised when prescribing it to populations susceptible to systemic hypoperfusion conditions, as it can lead to accumulation in the body and metabolic disturbances that may result in metformin-associated lactic acidosis. This severe complication is often underdiagnosed. To promote a better understanding of this topic, the present review focuses on the analysis of the clinical, pathophysiological, diagnostic, and management aspects of metformin-associated lactic acidosis, with particular attention to management through renal replacement therapies. The analysis will be based on the experience of a series of cases of metformin-associated lactic acidosis treated at a hospital clinical center in Chile.
摘要：
二甲双胍是2型糖尿病（T2DM）初始治疗的首选药物。虽然它的使用被广泛推荐，当给容易出现全身灌注不足的人群开药时，应谨慎行事。因为它可能导致体内积累和代谢紊乱，可能导致二甲双胍相关的乳酸性酸中毒。这种严重的并发症经常被诊断不足。为了促进对这一主题的更好理解，本综述侧重于临床分析，病理生理学，诊断,以及二甲双胍相关性乳酸性酸中毒的管理方面，特别注意通过肾脏替代疗法进行管理。该分析将基于智利医院临床中心治疗的一系列二甲双胍相关乳酸性酸中毒病例的经验。
