Fatal Metformin Overdose Presenting with Progressive Hyperglycemia
Jeffrey R. Suchard MD, Department of Emergency Medicine, University of California, Irvine School of Medicine
Thomas A. Grotsky MD, Department of Emergency Medicine, University of California, Irvine School of Medicine

Download the Paper (PDF format) - September 22, 2008 Tell a colleague about it. Printing Tips: Select 'print as image' in the Acrobat print dialog if you have trouble printing. This work has been peer reviewed.

ABSTRACT:

A 29-year-old man with no history of diabetes ingested over 60 grams of metformin in a suicide attempt. He presented to the emergency department with acute renal insufficiency, severe lactic acidosis, and rapidly-progressive hyperglycemia. The patient’s peak serum glucose level of 707 mg/dL is the highest yet reported in a case of metformin toxicity. Treatment included sodium bicarbonate infusion and hemodialysis, but the patient suffered several cardiac arrests with pulseless electrical activity and ultimately expired 25 hours after the ingestion.