#212 Metformin-Associated Lactic Acidosis (MALA) Explained | Symptoms, Pathophys, Diagnosis & Management

WhiteBoard Medicine - Emergency And Critical Care · Jan 30, 2026 · 14m

Metformin-associated lactic acidosis (MALA) is rare, but when it occurs, it carries significant morbidity and mortality. In this episode, we walk through a practical, clinician-focused approach to recognizing and managing MALA in the emergency department and ICU. We review the pathophysiology behind metformin-related lactic acidosis, common risk factors and precipitating conditions, and the clinical features that should raise concern for MALA. We also discuss the diagnostic approach, key laboratory findings, and management strategies, including supportive care and considerations for dialysis…