A history of renal failure (unless recovered for at least 6 months), lactic acidosis, recurrent or severe hypoglycemia, or significant chronic obstructive lung disease; patients will not be excluded for reversible episodes of elevated creatinine due to hypovolemia
Any condition associated with increased risk of metformin-associated lactic acidosis (e.g. congestive heart failure defined as New York Heart Association [NYHA] class III or IV functional status, history of acidosis of any type; habitual intake of 3 or more alcoholic beverages per day)
Prior history of lactic acidosis
Chronic (daily use for > 1 month) use of cimetidine (significant increase in metformin concentration and risk of lactic acidosis)
Iodinated contrast agents used in prior 48 hours (significant increase in metformin concentration and risk of lactic acidosis)
Subjects receiving metformin or other agents known to increase risk of lactic acidosis.
Any condition associated with increased risk of metformin-associated lactic acidosis (e.g., congestive heart failure defined as New York Heart Association [NYHA] class III or IV functional status; history of acidosis of any type; habitual intake of 3 or more alcoholic beverages per day)
Patients with history of lactic or any other metabolic acidosis
Subject currently being treated with biguanides or other agents known to increase risk of lactic acidosis
Patients with history of lactic or any other metabolic acidosis
Conditions which would increase risk of lactic acidosis including:\r\n* Known alcoholism or ingestion of more than 3 alcoholic beverages per day\r\n* History of congestive heart failure defined as New York Heart Association (NYHA) class III or IV\r\n* History of metabolic acidosis\r\n* Ongoing or active infection concerning for sepsis or systemic inflammatory response syndrome (SIRS)
Subjects must not have conditions associated with increased risk of metformin-associated lactic acidosis, including New York Heart Association class III or IV congestive heart failure, history of acidosis of any type, alcoholic liver disease, or habitual intake of 3 or more alcoholic beverages per day
EXCLUSION CRITERIA FOR REGISTRATION: subjects must not have conditions associated with increased risk of metformin-associated lactic acidosis, including New York Heart Association class III or IV congestive heart failure, history of acidosis of any type, alcoholic liver disease, or habitual intake of 3 or more alcoholic beverages per day
Patients with a history of chronic kidney disease or lactic acidosis
Any condition associated with increased risk of metformin-associated lactic acidosis; (e.g. congestive heart failure defined as New York Heart Association [NYHA] class III or IV functional status, history of acidosis of any type; habitual intake of 3 or more alcoholic beverages per day)
Has known renal tubular acidosis with serum bicarbonate < 20 mEq/L
Metabolic acidosis, acute or chronic, including ketoacidosis
Prior history of lactic acidosis or metabolic acidosis
Patient has a history of lactic acidosis, chronic kidney disease or a creatinine >= 1.2 mg/dl
Any condition associated with increased risk of metformin-associated lactic acidosis (e.g., congestive heart failure defined as New York Heart Association [NYHA] class III or IV functional status, history of acidosis of any type, intake of 3 or more alcoholic beverages per day on average over the past 6 months)
Patients with acute or chronic metabolic acidosis, lactic acidosis, or ketoacidosis; Note: during the study, metformin must be discontinued for 24 hours before and 48 hours after imaging involving intravenous (IV) contrast to minimize risk of lactic acidosis
Patient has any condition associated with increased risk of metformin-associated lactic acidosis (e.g. congestive heart failure defined as New York Heart Association [NYHA] class III or IV functional status, history of acidosis of any type; habitual intake of 3 or more alcoholic beverages per day)
Patients with plasma bicarbonate less than 22 mEq/L or history of lactic or any other metabolic acidosis
Subject currently being treated with biguanides or other agents known to increase risk of lactic acidosis.
Condition associated with increased risk of metformin-associated lactic acidosis:\r\n* New York Heart Association class III or IV heart failure\r\n* Intake of 3 or more alcoholic beverages per day\r\n* Known history of lactic acidosis
Patients with history or evidence of lactic acidosis or metabolic acidosis will be excluded
A history of metabolic acidosis, including ketoacidosis or increased risk of lactic acidosis
metabolic acidosis > - 10 milliequivalent (mEq)/L for more than 2 hours,
Prior history of lactic acidosis
Patients with plasma bicarbonate less than 22 mEq/L or history of lactic or any other metabolic acidosis
Patients with plasma bicarbonate less than 22 mEq/L or history of lactic or any other metabolic acidosis
Any condition associated with increased risk of metformin-associated lactic acidosis (prior renal failure or liver failure, history of acidosis of any type; habitual intake of 3 or more alcoholic beverages per day)
Patients with any condition associated with increased risk of metformin-associated lactic acidosis (e.g., congestive heart failure defined as New York Heart Association class III or IV functional status, history of acidosis of any type)
Have a prior history of lactic acidosis by self-report
History of lactic acidosis
Have a history of lactic acidosis or risk factors for lactic acidosis
No condition associated with increased risk of metformin-associated lactic acidosis (e.g. congestive heart failure defined as New York Heart Association [NYHA] class III or IV functional status, history of acidosis of any type; habitual intake of 3 or more alcoholic beverages per day)
Active or history of lactic acidosis, metabolic acidosis, or diabetic ketoacidosis
History of lactic acidosis as per prior medical records or provided by the patient
Metabolic acidosis, acute or chronic; acidosis will be defined a blood pH < 7.35; acidosis will be suspected if serum bicarbonate is < 22 mEq/L; in such cases, venous blood pH would be checked to confirm or exclude acidosis
Patients with plasma bicarbonate less than 22 mEq/L or history of lactic or any other metabolic acidosis