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Metformin increases skeletal muscle lactate production in pigs: a microdialysis study


Lactic acidosis during metformin intoxication is mainly attributed to impaired hepatic lactate clearance [1]. The aim of this present work was to clarify whether metformin at high dose also increases skeletal muscle lactate production.


Reverse microdialysis was used in six healthy, sedated and mechanically ventilated pigs, equipped with two skeletal muscle catheters (CMA Microdialysis AB, Sweden). Following a baseline recording, a continuous infusion of saline (control) or metformin diluted in saline (1 mol/l) began. Outflow lactate concentration was measured every 3 hours, up to 12 hours.


Data are presented as the mean and standard deviation in Figure 1. The interaction between infusion (saline vs. metformin) and time was statistically significant (P = 0.02; two-way repeated-measures ANOVA).

Figure 1
figure 1

Muscle lactate level with saline or metformin infused by reverse microdialysis.


In skeletal muscle, a high dose of metformin increases interstitial lactate levels, a finding consistent with local lactate overproduction.


  1. Lalau JD: Drug Saf. 2010, 33: 727-740. 10.2165/11536790-000000000-00000

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Protti, A., Properzi, P., Magnoni, S. et al. Metformin increases skeletal muscle lactate production in pigs: a microdialysis study. Crit Care 15 (Suppl 1), P364 (2011).

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  • Lactate
  • Skeletal Muscle
  • Metformin
  • Continuous Infusion
  • Lactate Level