Phenformin and lactic acidosis in a diabetic and a nondiabetic.

Two patients, each with a history of taking "diabetes pills," which proved to be phenformin, presented to the emergency department. The first, a 56-year-old female diabetic, on daily medication was symptomatic. The second, a non-diabetic 21-year-old man had attempted suicide using his grandmother's phenformin tablets. Both patients had lactic acidosis. The causal role of phenformin is discussed and the need for early recognition and aggressive treatment is stressed.