A rare but very serious complication of metformin therapy is:

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Lactic acidosis is a rare but potentially life-threatening complication of metformin therapy, especially in patients with impaired renal function or predisposing conditions such as sepsis or liver disease. It occurs due to the accumulation of lactic acid in the bloodstream and can result in symptoms such as nausea, vomiting, abdominal pain, and respiratory distress. Treatment involves immediate discontinuation of metformin and supportive measures such as hydration and correction of acid-base imbalances. Hyperkalemia (A) is not a common complication of metformin therapy, and uncompensated acidosis (C) or alkalosis (D) are unlikely to occur with this medication.

A Rare but Very Serious Complication of Metformin Therapy Is