What type of metabolic acidosis is associated with metformin use?

The correct answer, high anion gap metabolic acidosis, is associated with metformin use primarily due to the risk of lactic acidosis. Metformin can lead to the accumulation of lactate, particularly in situations where there is impaired renal function, dehydration, or severe hypoxia. This accumulation of lactate results in elevated levels of acid in the blood, contributing to an increased anion gap.

In clinical practice, a high anion gap metabolic acidosis typically arises from conditions that lead to the accumulation of organic acids or toxins, such as lactic acid in this case. The presence of elevated lactate levels due to metformin usage highlights the importance of monitoring patients, especially those with compromised renal function, to prevent this serious complication.

Understanding the underlying mechanisms of high anion gap metabolic acidosis in the context of metformin can aid in timely diagnosis and management of affected patients, ensuring that the benefits of the medication outweigh the risks.