Metformin after Bariatric Surgery - an Acid Problem.

Metformin is the oral drug of fi rst choice in type 2 diabetes. Therefore a large number of patients undergoing bariatric surgery will be on Metformin treatment. However, use of Metformin has been associated with lactate acidosis. Weight loss following bariatric surgery is most pronounced during the fi rst weeks after the operation and this creates a phase of negative energy balance with ketone body formation. To shed more light on this situation we measured ketone bodies in 90 patients 5 days-18 months after bariatric surgery. Ketone bodies were markedly elevated during the fi rst 3-4 months. Metformin use should therefore be critically reconsidered after bariatric operations. [ABSTRACT FROM AUTHOR]