{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:08:06Z","timestamp":1788404886900,"version":"build-2803163510"},"reference-count":27,"publisher":"American Diabetes Association","issue":"7","license":[{"start":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T00:00:00Z","timestamp":1592524800000},"content-version":"vor","delay-in-days":57,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["Center for Diabetes Translation Research P30-DK-092986"],"award-info":[{"award-number":["Center for Diabetes Translation Research P30-DK-092986"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006379","name":"Office of Research and Development","doi-asserted-by":"publisher","award":["CX000570-07"],"award-info":[{"award-number":["CX000570-07"]}],"id":[{"id":"10.13039\/100006379","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To compare the risk of lactic acidosis hospitalization between patients treated with metformin versus sulfonylureas following development of reduced kidney function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>This retrospective cohort combined data from the National Veterans Health Administration, Medicare, Medicaid, and the National Death Index. New users of metformin or sulfonylureas were followed from development of reduced kidney function (estimated glomerular filtration rate [eGFR] &amp;lt;60 mL\/min\/1.73 m2 or serum creatinine \u22651.4 mg\/dL [female] or 1.5 mg\/dL [male]) through hospitalization for lactic acidosis, death, loss to follow-up, or study end. Lactic acidosis hospitalization was defined as a composite of primary discharge diagnosis or laboratory-confirmed lactic acidosis (lactic acid \u22652.5 mmol\/L and either arterial blood pH &amp;lt;7.35 or serum bicarbonate \u226419 mmol\/L within 24 h of admission). We report the cause-specific hazard of lactic acidosis hospitalization between metformin and sulfonylureas from a propensity score\u2013matched weighted cohort and conduct an additional competing risks analysis to account for treatment change and death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The weighted cohort included 24,542 metformin users and 24,662 sulfonylurea users who developed reduced kidney function (median age 70 years, median eGFR 55.8 mL\/min\/1.73 m2). There were 4.18 (95% CI 3.63, 4.81) vs. 3.69 (3.19, 4.27) lactic acidosis hospitalizations per 1,000 person-years among metformin and sulfonylurea users, respectively (adjusted hazard ratio [aHR] 1.21 [95% CI 0.99, 1.50]). Results were consistent for both primary discharge diagnosis (aHR 1.11 [0.87, 1.44]) and laboratory-confirmed lactic acidosis (1.25 [0.92, 1.70]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Among veterans with diabetes who developed reduced kidney function, occurrence of lactic acidosis hospitalization was uncommon and not statistically different between patients who continued metformin and those patients who continued sulfonylureas.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc19-2391","type":"journal-article","created":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T20:56:12Z","timestamp":1587675372000},"page":"1462-1470","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":28,"title":["Hospitalization for Lactic Acidosis Among Patients With Reduced Kidney Function Treated With Metformin or Sulfonylureas"],"prefix":"10.2337","volume":"43","author":[{"given":"Patricia Y.","family":"Chu","sequence":"first","affiliation":[{"name":"1Geriatric Research Education Clinical Center, Tennessee Valley Healthcare System, Veterans Health Administration, Nashville, TN"},{"name":"2Department of Medicine, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber J.","family":"Hackstadt","sequence":"additional","affiliation":[{"name":"3Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Chipman","sequence":"additional","affiliation":[{"name":"4Department of Population Health Sciences, University of Utah, Salt Lake City, UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie R.","family":"Griffin","sequence":"additional","affiliation":[{"name":"1Geriatric Research Education Clinical Center, Tennessee Valley Healthcare System, Veterans Health Administration, Nashville, TN"},{"name":"2Department of Medicine, Vanderbilt University Medical Center, Nashville, TN"},{"name":"5Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3203-1608","authenticated-orcid":false,"given":"Adriana M.","family":"Hung","sequence":"additional","affiliation":[{"name":"1Geriatric Research Education Clinical Center, Tennessee Valley Healthcare System, Veterans Health Administration, Nashville, TN"},{"name":"2Department of Medicine, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Robert A.","family":"Greevy","sequence":"additional","affiliation":[{"name":"3Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos G.","family":"Grijalva","sequence":"additional","affiliation":[{"name":"1Geriatric Research Education Clinical Center, Tennessee Valley Healthcare System, Veterans Health Administration, Nashville, TN"},{"name":"5Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Elasy","sequence":"additional","affiliation":[{"name":"1Geriatric Research Education Clinical Center, Tennessee Valley Healthcare System, Veterans Health Administration, Nashville, TN"},{"name":"2Department of Medicine, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6555-2055","authenticated-orcid":false,"given":"Christianne L.","family":"Roumie","sequence":"additional","affiliation":[{"name":"1Geriatric Research Education Clinical Center, 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