You know, except for the fact that he suffered a fatal heart attack during dialysis, and had gone untreated for diabetes for quite some time. Add on to that fact that he had just started metformin, and he should have had blood work to make certain he was not pre-disposed to acidosis. The article never specifically provides a cause for 'how' creatine would cause this to occur, and acidosis can also be induced through heavy exercise.
His renal condition was already poor by the time he started diabetes treatment because the diabetes had been untreated for so long. Also, if this was such a large problem there would be more than a single piece of case literature that has not been properly edited.
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