Aggravation of Metformin-induced Lactic Acidosis by Angiotensin II Type 1 Receptor Blocker

The concurrent use of angiotensin II receptor type 1 blocker (ARB) and metformin has become common among patients with type 2 diabetes mellitus (DM). We present an unusual case of metformin induced lactic acidosis with acute renal failure, which may be induced by dehydration and aggravated by ARB. This condition developed in a patient with type 2 diabetes who had no previous risk factors for lactic acidosis.