Originally, scientists developed this medication to help people with type 2 diabetes manage their blood sugar levels
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Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic impairment, and mitochondrial diseases [see Warnings and Precautions (5.1)]
Finally, when compared with placebo, SGLT-2 inhibitors are associated with a robust reduction of hospitalization for HHF and renal outcome, and a moderate reduction of CV and total death, and MACE [13]
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