Using metformin in diabetes patients with kidney disease

M etformin will be used in more diabetes patients with kidney disease as FDA labeling catches up with the evidence. We're used to avoiding metformin if serum creatinine is over 1.5 mg/dL for men or over 1.4 mg/dL in women due to fear of lactic acidosis. But lactic acidosis is EXTREMELY rare, even in kidney disease. And now labeling will base metformin dosing on…