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ISSN: 2641-1725

LOJ Medical Sciences

Case Report(ISSN: 2641-1725)

Fatal Intoxication with Metformin and Gliclazide- Case Report Volume 6 - Issue 1

Peter Jackuliak1, Magdaléna Kovářová1, Andrea Martonová2, Viera Žufková³, Andrea Gažová4*, Ján Kyselovič1 and Juraj Payer1

  • 1Department of Internal Medicine, Comenius University Faculty of Medicine, Slovakia
  • 2Department of Anaesthesiology and Intensive Medicine, Comenius University Faculty of Medicine, Slovakia
  • 3Department of Languages, Comenius University Faculty of Pharmacy, Bratislava, Slovakia
  • 4Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Slovakia

Received: December 01, 2021   Published: December 8, 2021

*Corresponding author: Andrea Gažová, Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Slovakia

DOI: 10.32474/LOJMS.2021.06.000229

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Introduction: Biguanides (metformin) and sulfonylurea molecule (gliclazide) are oral antihyperglycemic drugs. Metformin can make lactate accumulation in patients with hepatic or renal failure or in patients with a suicide attempt. Gliclazide has very low toxicity, and it can develop acute renal failure in patients with massive ingestion in a suicide attempt.
The patient’s Primary Concerns and Critical Clinical Findings: A 53-year-old patient with a personal history of type 2 diabetes mellitus was treated with metformin 1000 mg twice daily and gliclazide 60 mg twice daily. On December 26th, 2018, in the evening hours, he consumed 90 tablets of metformin 1000 mg (total dose 90 grams) and 95 tablets of gliclazide 60 mg (total dose 5.7 grams) for suicide. According to the report, he had been sicking all night and suffered from muscle pain, diarrhoea, and vomiting.
The Primary Diagnoses, Interventions, and Outcomes: We concluded the diagnosis as a high anion gap metabolic acidosis. As a consequence of metformin intoxication, lactate level was furthermore elevated (24 mM).
Conclusion: Metformin and gliclazide are commonly using as effective drugs in patients with type 2 diabetes mellitus. Our case report described fatal intoxication with metformin and gliclazide. The aim is to remember the risk of daily used antidiabetic drugsin high doses, in combinations, they can lead to pancreatitis, renal failure, or so long-known lactic acidosis.

Keywords: Intoxication; Metformin; Gliclazide; Case report

Abbreviations: T2DM: type 2 Diabetes Mellitus; ECTRs: Extracorporeal Treatments; BP: Blood Pressure; BPM: Beat per Minute; BE: Base excess; BB: Buffer Base; ICU: Intensive Care Unit; CPCR: Cerebral Cardiopulmonary Resuscitation; DIP: Drug-induced pancreatitis

Abstract| Introduction| Patient Information| Clinical Findings| Diagnostic Assessment| The Therapeutic Intervention| Follow-up and Outcomes| Discussion| Patient Perspective| Conclusion| References|


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