You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is In the management of diabetes mellitus, lactic acidosis is caused by which of the following? and explain in detail?
Metformin:- S/E: Lactic acidosis Megaloblastic anemia To prevent lactic acidosis, Metformin is to be avoided in high risk patients: Old patients Pt. with renal failure Pt. with liver diseases CHF Tolbutamide (1st gen. Sulfonylureas) - s/e - Hypoglycemia, weight gain. Glipizide (2nd gen. Sulfonylureas) - s/e - Hypoglycemia Pioglitazone - acts by stimulating PPAR-g - reversal of Insulin resistance, s/e - hepatotoxic, edema and Increased risk of urinary bladder cancer