Fast-Track Dialysis Protocol Cuts Metformin Emergency Deaths, Study Shows
A new study from Thailand shows that fast action can save lives during metformin-related emergencies. Researchers found that a quick dialysis pathway nearly halved deaths from metformin-associated lactic acidosis, also known as MALA. As a result, the team believes rapid, organized care should become standard in hospitals.MALA is rare but dangerous. It develops when lactic acid builds faster than the body can remove it. The research team created a simple protocol to help doctors diagnose the condition earlier and start treatment sooner.
New Protocol Focuses on Rapid Dialysis
The approach encouraged medical teams to begin dialysis as quickly as possible. They used several methods, including intermittent hemodialysis and continuous kidney replacement therapy. Maharat Nakhonratchasima Hospital adopted this protocol, while Burirum Hospital served as a comparison site.The team reviewed 347 cases over five years. They studied outcomes before and after the new protocol to see if it made a difference.
Major Improvements in Survival
The results were striking. The 30-day death rate at Maharat Hospital dropped from 25.7 percent to 13.9 percent after the protocol began. Meanwhile, Burirum Hospital showed no improvement. In addition, awareness of MALA rose sharply among staff, which helped speed up care.Door-to-dialysis time also improved. The wait dropped from 870 minutes to 690 minutes, giving patients a better chance of recovery.
Why Early Action Matters
Experts say the findings show why fast-track care is essential. MALA progresses quickly, but early dialysis can reverse the dangerous acid buildup. Therefore, hospitals that use structured protocols see more consistent care and better survival.
Understanding Metformin and MALA
Metformin is a common and generally safe treatment for type 2 diabetes. MALA remains rare, but certain conditions, such as kidney disease or severe infections, increase risk. Symptoms often include nausea, rapid breathing, or weakness. Quick treatment, especially dialysis, improves outcomes and saves lives.
