Abstract
Historically, metformin was withheld before surgery for fear of metformin-associated lactic acidosis. Currently, however, this risk is deemed to be low and guidelines have moved towards the continuation of metformin. We hypothesized that continuing metformin peri-operatively would lower postoperative serum glucose level without an effect on plasma lactate levels. We performed a single-blind multicentre randomized controlled trial in people with type 2 diabetes mellitus scheduled for non-cardiac surgery and continued (MF+ group) or withheld (MF- group) metformin before surgery. The main outcome measures were the differences in peri-operative plasma glucose and lactate levels. We randomized 70 patients (37 MF+ group and 33 MF- group) with type 2 diabetes mellitus. Postoperative glucose levels were similar in the MF+ and the MF- groups (8.2 +/- 1.8 vs 8.3 +/- 2.3mmol/L P=.95) Although preoperative lactate levels were slightly higher in the MF+ group compared with the MF- group (1.5 vs 1.2mmol/L; P=.02), the postoperative lactate levels were not significantly different (1.2 vs 1.0mmol/L; P=.18). In conclusion, continuation of metformin during elective non-cardiac surgery does not improve glucose control or raise lactate levels to a clinically relevant degree
Original language | English |
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Pages (from-to) | 749-752 |
Journal | Diabetes, obesity & metabolism |
Volume | 20 |
Issue number | 3 |
Early online date | 2017 |
DOIs | |
Publication status | Published - 2018 |