Influence of disease and drug risk factors on metformin dose adjustment: A retrospective study of outpatients in Nablus.

Waleed M Sweileh

Abstract


Background: Metformin may, in the presence of certain risk factors, cause serious lactic acidosis. The aim of this study was to investigate the presence of risk factors for lactic acidosis among diabetic patients and to determine whether metformin daily dose was influenced by the presence of these risk factors or not. Methods: This is a retrospective study of one hundred and eighteen diabetic patients receiving metformin. Information about disease status and medication profile of the patients were retrieved from patients’ medical files. Data were coded and entered using SPSS for analysis and graphics. Results: Approximately, two thirds (74/118, 62.7%) of the included patients had a least one disease risk factor for lactic acidosis. Of those patients, (48/74; 64.9%) had a dose adjustment, with congestive heart failure and renal impairment being the risk factors most likely to result in a dose adjustment. More than one third (38%) of metformin patients were co-prescribed ACE-I or NSAIDs. The dose of metformin was insignificantly influenced by the co-administration of drug risk factors. Conclusion: Metformin total daily dose was significantly influenced by the presence of disease risk factors and was insignificantly influenced by the co-administration of drug risk factors. Short running title: Risk Factors and Metformin Dose.

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