DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20170136

Dyselectrolytemia in hyperglycaemic crisis patients with uncontrolled non-insulin dependent diabetes mellitus

Anup K Rana, Subhashree Ray

Abstract


Background: Diabetes is a group of disorders characterized by high blood glucose levels. Disturbances in serum electrolytes sodium (Na+), potassium (K+) and chloride (Cl) is found in diabetes. The objective of the study was to investigate the disturbances in concentrations of serum electrolytes in hyperglycaemic crisis, uncontrolled non – insulin dependent diabetes mellitus patients: early detection and treatment of such abnormalities, leading to better quality of life of patients.

Methods: Data was collected prospectively over a period of 1 year and analyzed retrospectively. Of the 131 subjects included in the study, two groups were formed; 60 hyperglycaemic diabetes mellitus patients and 71 healthy volunteer as controls. Biochemical analysis for Na+, K+, Cl- was performed by ISE method using Easy – lyte automatic electrolyte analyzer. The random glucose levels were estimated by direct Hexokinase enzymatic method using Cobas Interga 400. Unpaired t-test was done to find out the difference between the two paired groups and Pearson's correlation was calculated to know the correlations between electrolytes and random glucose levels.

Results: In uncontrolled diabetes mellitus, increase in serum Na+ and Cl- levels were observed to be highly significant (p<0.001, respectively) while that of K+ showed significant (p<0.05) alterations

Conclusions: The study demonstrated significant association of Na+, K+ and Cl- with hyperglycaemia in patients with hyperglycaemic crisis in uncontrolled type 2 diabetes mellitus. So, electrolytes should be measured during the treatment of type 2 diabetes mellitus.


Keywords


Diabetes mellitus, Electrolytes, Hyperglycaemia, Random blood glucose

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References


Canadian diabetes association. Clinical practice guidelines expert committee. Diagnosis, classification and diagnosis of diabetes, pre – diabetes and metabolic syndrome. Can J Diabetes. 2013;37:S8-11.

American Diabetes Association. Diagnosis and Classification and Diagnosis of Diabetes Mellitus. Diabetes Care. 2010;33(1):S62-9.

Wikipedia contributors. Wikipedia, The Free Encyclopedia. San Francisco: Wikimedia Foundation, Inc. 2004. Available from: https://en.wikipedia.org/ w/ index.php?title=Water-electrolyte_imbalance&oldid=686324368

Talabani N. Serum electrolytes and lipid profile in non – insulin dependent diabetes mellitus patients. Asian J Med Scien. AJMS. 2014;6(3):38-41.

Liamis G, Liberopoulos E, Barkas F, Elisaf M. Diabetes mellitus and electrolyte disorders. World J Clin Cases. 2014;2(10):488-96.

Sotirakopoulos N, Kalogiannidou I, Tersi M, Armentzioiou K, Sivridis D, Mavromatidis Kl. Acid–Base and Electrolyte Disorders in Patients with Diabetes Mellitus. Saudi Journal of Kidney Diseases and Transplantation, Saudi J Kidney Dis Transpl. 2012;23(1):58-62.

Biff FP, Deborah JC. Electrolyte and Acid – Base Disturbance in Patients with Diabetes Mellitus. New Eng J Med. NEJM. 2015;373:548-59.

American diabetic association. Hyperglycemic Crises in Patients with Diabetes Mellitus. Clinical Diabetes. 2001;19(2):82-90.

Sharma A, Hirulkar NB, Ranka P. Effect of Hyperglycemia on Electrolytes Imbalance, Int J Pharmaceu Bio Archives. IJPBA. 2011;2(1):526-33.

Kavelaars J, Tamsma JT, Meinders AE. Hypernatremia in a non-insulin dependent (type 2) diabetic patient with central diabetes insipidus. Neth J Med. 2001;58(3):150-4.

Danowski TS, Nabarro JDN. Hyperosmolar and Other Types of Nonketoacidotic Coma in Diabetes. Diabetes. 1965;14(3):162-5.

McNair P, Madsbad S, Christiansen C, Christensen MS, Transbøl I. Hyponatremia and hyperkalemia in relation to hyperglycemia in insulin-treated diabetic out-patient,Clin Chim Acta. 1982;120(2):243-50.

Liamis G, Tsimihodimos V, Elisaf M. Hyponatremia in Diabetes Mellitus: Clues to Diagnosis and Treatment, Diabetes & Metabolism. J Diabetes Metab. 2015;6(560):1-3.

Uribarri J, Oh MS, Carroll HJ. Hyperkalemia in diabetes mellitus, J Diabet Complications. 1990;4(1):3-7.

Abramson E, Arky R. Diabetic Acidosis With Initial Hypokalemia Therapeutic Implications. JAMA. 1966;196(5):401-3.

GrunFeld C, Chappell DA. Hypokalemia and Diabetes Mellitus. AJM. 1983;75(4):553-4.

Hammeke M, Bear R, Lee R, Goldstein M, Halperin M. Hyperchloremic metabolic acidosis in metabolic acidosis-A case report and discussion of pathophysiologic mechanisms. Diabetes. 1978;27(1):16-20.

Ribeiro-Oliveira A Jr, Nogueira AI, Pereira RM, Boas WW, Dos Santos RA, Simões e Silva AC. The renin–angiotensin system and diabetes – An update,Vascular Health and Risk Management. 2008;4(4):787-803.

Hoong SL, Robert JM, Gregory YHL. Diabetes Mellitus, the Renin ­ Angiotensin Aldosterone System, and the Heart, Arch Intern Med. 2004;164(16):1737-48.

Hayashi T, Takai S, Yamashita C. Impact of the renin-angiotensin-aldosterone-system on cardiovascular and renal complications in diabetes mellitus,Curr Vasc Pharmacol. 2010;8(2):189-97.

Gilberta G, Leonardo AS, Silvia R. The renin – angiotension – aldosterone system, glucose metabolism and diabetes. Trends in Endocrinology & Metabolism. 2005;16(3):120-6.