Systematic Reviews
Copyright ©The Author(s) 2022.
World J Diabetes. Aug 15, 2022; 13(8): 654-664
Published online Aug 15, 2022. doi: 10.4239/wjd.v13.i8.654
Table 1 The commonly reported symptoms (mean ± SD)
Parameter
Number of patients (n = 242)
Age59.3 (16) yr
Gender, n (%)Females, 126 (52.1)
Males, 115 (47.5)
Not mentioned, 1 (0.4)
Clinical presentation, n (%)Vomiting, 127 (52.5)
Abdominal pain, 96 (40)
Altered mental status, 87 (36)
Shock, 43 (17.8)
Breathlessness, 41 (16.9)
Loss of consciousness, 28 (11.6)
Anuria, 22 (8.3)
Cardiac arrest, 5 (2)
Others, 15 (6.2)
Comorbidities, n (%)Diabetes, 214 (88.4)
Hypertension, 94 (38.8)
Coronary artery disease, 34 (14.1)
Chronic kidney disease, 41 (16.9)
Chronic liver disease, 6 (2.5)
Others, 24 (9.9)
None, 22 (9.9)
Not mentioned, 2 (0.8)
History of psychiatric illness, n (%)30 (12.4)
History of metformin use, n (%) 214 (88.4)
Type of ingestion, n (%)Chronic use, 185 (76.4)
Suicidal, 52 (21.5)
Accidental, 3 (1.2)
Unclear, 1 (0.4)
Not mentioned, 1 (0.4)
Urine toxicology screen, n (%)15 (6.2)
Time to presentation after acute intoxication (h)10.9 ± 13.8
Hypoglycemia, n (%)59 (24.4)
Therapies to reduce absorption, n (%)Activated charcoal, 16 (6.6)
Gastric lavage, 14 (5.8)
Whole bowel irrigation, 1 (0.4)
Need for organ support, n (%)RRT, 166 (68.6)
Vasopressors, 142 (58.7)
Invasive mechanical ventilation, 128 (52.9)
Extracorporeal membrane oxygenation, 2 (0.8)
Type of RRT, n (%)Haemodialysis, 83 (34.3)
Continuous RRT, 60 (24.8)
Slow low-efficiency dialysis, 13 (5.4)
Peritoneal dialysis, 6 (2.5)
Haem-adsorption columns, 3 (1.2)
Plasmapheresis, 1 (0.4)
Other treatments given, n (%)Sodium bicarbonate, 158 (65.3)
Glucose/insulin, 15 (6.2)
Methylene blue, 2 (0.8)
ECMO, 2 (0.8)
L-carnitine, 1 (0.4)
High dose vitamin C, 1 (0.4)
Development of organ failure, n (%)Renal, 179 (74)
Cardiac, 144 (59.5)
Pulmonary, 114 (47.1)
Neurological, 88 (36.4)
Liver, 18 (17.4)
Haematological, 2 (0.8)
Days on RRT3.1 ± 6.7
Days on IMV2.2 ± 5.1
Number of sessions of RRT2 ± 2.6
Time of initiation of RRT after presentation (h)6.3 ± 12.7
Days in hospital7.3 ± 11.4
Days in ICU4.1 ± 6.6
Outcome, n (%)Alive, 192 (79.3)
Death, 48 (19.8)
Not mentioned, 2 (0.8)
Table 2 Arterial blood gas parameters
Parameter
Mean
Standard deviation
Range
pH, at presentation7.000.116.38-7.5
Lactates, at presentation (mmol/L) 15.77.62.1-40.2
Bicarbonate, at presentation (mmol/L)7.761–23.7
Anion Gap, at presentation 3210.810-61
Lowest pH reported6.970.226.28–7.5
Highest lactates reported (mmol/L)188.62.4-48
Serum metformin concentration (mcg/mL)108.72800.9-2020