What is the primary cause of lactic acidosis in patients with type 2 diabetes mellitus?

A Impaired glucose uptake in muscles
B Increased glucose production in the liver
C Defective mitochondrial function
D Insulin resistance and metformin use ✓

Explanation

Lactic acidosis is a rare but serious side effect of metformin, particularly in patients with type 2 diabetes mellitus who have impaired kidney function or take the medication in high doses.

Source

American Diabetes Association
Metabolic and Nutritional Disorders Endocrinology Diabetes Mellitus Hard MEDICAL Confidence: high