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Current guidelines recommend holding metformin in hospitalized patients, given hospitalized patients' potential excess risk for lactic acidosis due to hemodynamic instability, hypoxia, congestive heart failure (CHF), or acute kidney injury. However, critics contend that many patients without contraindications should continue to receive metformin in the hospital since no evidence shows that it is harmful, and it might have benefits such as avoiding hypoglycemia, which is more common with insulin.
Researchers conducted a propensity-matched observational study in 67,000 adult patients (97% men) with type 2 diabetes who were admitted to Veterans Health Affairs (VHA) hospitals. Half of patients continued and half discontinued metformin during hos…