Low recruitment rate and an inability to meet power.

A randomized study of continuing versus holding metformin during hospitalizations to internal medicine services to determine the effects on glucose control, acidosis, abdominal symptoms, length of stay, and mortality.

The purpose of this study is to determine what the effects of the routine practice of holding metformin in hospitalized patients with type 2 diabetes are on outcomes.

The objectives of this study are to determine how holding versus continuing metformin during hospitalization to an internal medicine service affects the incidences of lactic acidosis, mean anion gap, mean glucose levels, low and very high blood sugars, GI effects after discharge, lack of continuation of metformin upon discharge, mean glucose levels, lengths of stay, and 30-day mortality.

Inclusion Criteria:

• Adult (18+ years of age)
• Admitted to an internal medicine service.
• On Metformin prior to admission.

Exclusion Criteria:

• Inability to take oral medications
• eGFR < 30 ml/min/1.73 m2
• Dialysis
• Current Acidosis (pH < 7.35) including diabetic ketoacidosis
• Child-Turcotte-Pugh class C hepatic cirrhosis
• Acute Decompensated Heart Failure
• Cognitively impaired and/or unable to consent
• Lack of or unwillingness to share contact information
• Pregnant women