What complication can occur due to Metformin use before a CT scan?

Metformin is a commonly prescribed medication for managing type 2 diabetes, but its use carries specific risks, particularly in the context of procedures involving contrast agents, like a CT scan. One significant complication associated with metformin in this setting is lactic acidosis.

Lactic acidosis is a serious metabolic condition that can occur when there is an accumulation of lactic acid in the body, leading to a decrease in blood pH. Metformin has been linked to this condition, mainly because it works by inhibiting gluconeogenesis in the liver, which can lead to increased lactate production, especially in situations where renal function may be compromised.

When patients receive intravenous contrast for a CT scan, there is a risk of acute kidney injury, particularly in those who already have existing renal problems or in the elderly population. Impaired kidney function can lead to the accumulation of metformin and, consequently, increase the risk of lactic acidosis. For this reason, it is generally advised to withhold metformin prior to such imaging procedures and to monitor renal function afterwards before resuming its use.

While acute pancreatitis, hypoglycemia, and cardiac dysrhythmias are concerning in patients with diabetes or those using antidiabetic medications, they are