Acidose lactique par surdosage en metformine après chirurgie pour une fracture de hanche

Metformin is an oral antidiabetic agent, belonging to the class of the biguanids. It enhances the sensitivity to insulin by decreasing the hepatic glucose production and increasing its peripheral use. The incidence of metformin-associated lactic acidosis (MALA) is very low when the appropriate rules of administration are respected but a 50 % mortality rate may be observed. It is worth noticing that guidelines are not followed in more than half of the cases. This emphasizes the need for better education of physicians and patients, especially during the perioperative period.