Contrast media and metformin: guidelines to diminish the risk of lactic acidosis in non-insulin-dependent diabetics after administration of contrast media

The purpose of this study was to establish guidelines on how to avoid metfo rmin-induced lactic acidosis following intravascular use of contrast media. We reviewed articles published in international journals. No conclusive ev idence was found to indicate that the intravascular use of contrast media p recipitated the development of metformin-induced lactic acidosis in patient s with normal S-creatinine (<130 mu mol/l). The complication was almost alw ays observed in non-insulin-dependent diabetic patients with decreased rena l function before injection of contrast media. Guidelines for the use of co ntrast media in this group of patients are proposed.