DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160803

Role of hyperglycemia in the pathogenesis of Na+/K+ disturbance

Kumari Shipra Parmar, Samir Singh, Ganesh Kumar Singh

Abstract


Background: Electrolytes play an important role in maintaining acid-base balance, blood-clotting, control body fluid, muscle contraction, nerve conduction. The diabetic patients develop frequently a constellation of electrolyte imbalance. Imbalance in electrolyte concentration may affect the course of diabetes and its management. It has been reported that there is an inverse relationship between serum sodium (Na+) and potassium (K+) levels in diabetic patients. The aim of present study was to determine whether such relation is seen in context of Nepal and whether this inverse relation depends upon serum glucose levels in diabetic patients for their glycemic control.

Methods: This is a retrospective study performed on records of 135 diabetic patients who were treated at out-patient clinic of Kist Medical College and Teaching Hospital from 15 June 2015-15 July 2015. Fasting blood glucose (FPG) level was analyzed with semiautomatic analyzer- humalyzer 3000 by GOD-POD method and Na+ and K+ levels were analyzed with ion selective electrode- nova electrolyte. The relationship among serum Na+ level, serum K+ levels and Fasting plasma glucose levels were determined by SPSS version 20.

Results: Serum Na+ level was insignificantly negatively correlated (r=-0.091, p=0.296) with FPG level while a positive correlation of serum K+ level (r=0.235, p=0.006) was seen with FPG level and an inverse relation between serum Na+ and K+ was found. Age showed insignificant negative correlation with serum Na+ (r= -0.203, p=0.018), insignificant positive correlation with K+ (r=0.067, p=0.443) and insignificant negative correlation with FPG (r= -0.045, p=0.608).

Conclusions: Hyperglycemia disrupts the balance of serum Na+ and K+ in uncontrolled diabetes mellitus.


Keywords


Hyperglycemia, Serum Na+, Serum K+, FPG, DM

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References


Devlin TM. Textbook of Biochemistry with Clinical Correlations. 7th ed. USA : John Wiley & Sons, Inc. 2011.

Hosen B, Buiyan AR, Hasan S, Hassan M, Uddin M. Estimation of Serum Electrolytes in non-Insulin Dependent (type 2) Diabetic Patients in Bangladesh, Scientific research journal (SCRJ). 2014;2(4):29-32.

Bao Y. Glycated haemoglobin A1c for diagnosing diabetes in Chinese population: cross sectional epidemiological survey: BMJ. 2010;340;c2249.

Martini FH, Halyard RA. Fluid electrolytes and acid-base balance. In: Fundamentals of Anatomy and Physiology Interactive. (Media Edition) 4th ed; USA; Person Education, Inc. 1998.

Ojiako OA, Chikezie PC. Blood Na+/K+ and Cl- Levels of Hyperglycemic rats Administered with traditional Herbal Formulations, Pharmacognosy Communications. 2015;5(2):140-5.

DeFronzo RA, Davidson JA, Prato D. The role of kidneys in glucose homeostasis: a new path towards normalizing glycemia, Diabetes, Obesity and Metabolism. 2012;14:5-14.

Al-Jameil N. Estimation of Serum Electrolytes in Diabetes Patients of Saudi Region, Life. Sci. J. 2014;11(7):378-80.

Saito T, Ishikawa S, Higashiyama M. Inverse distribution of serum sodium and potassium in uncontrolled in patients with diabetes mellitus. Endocr. J. 1999;46(1):75-80.

Staruschenko A. Regulation of transport in the connecting tubule and cortical collecting duct, Compr Physol. 2012;2:1541-84.

Liamis G, Vasilios T, Elias M. Hyponatraemia in Diabetes Mellitus: Clues to Diagnosis and Tratment, J Diabetes Metab. 2015;6(5):559-61.

McDonnell CM, Pedreira CC, Vadamalayan B, Cameron FJ, Werther GA. Diabetic ketoacidosis, hyperosmolarity and hypernatremia: are highcarbohydrate drinks worsening initial presentation? Ped. Diabet. 2005;6:90-94.

Kavelaars J, Tamsma JT, Meinders AE. Hypernatremia in a non-insulin dependent (type 2) diabetic patient with central diabetes insipidus. The Netherlands Journal of Medicine. 2001;58:150-4.

Liamis G, Liberopoulos E, Fotios B, Elias M. Diabetes Mellitus and electrolyte disorders, World Journal of Clinical Cases. 2014;2(10):488-96.

Somogyi J, Kiss G, Pentek E, Cser Melys P. Diabetes mellitus as a general membrane disease and its consequences. Orv. Hetil. 2001;142:1781-8.

Totan AR, Greaby M. Effect of chronic hyperglycemia and vanadate treatment on erythrocyte Na+/K+-ATPase and Mg++- ATPase in streptozotocin in diabetic rats. Acta. Pol. Pharm. 2002;59:307-11.

Kraat G, Wolf E, Gruska S. Potassium permeability in diabetics and non-diabetics with and without renal insufficiency. Exp. Clin. Endocrinol. Diabetes. 1997;105(2):19-21.

Khalid R, Khalid S, Khaled AR, Roderick H, Abdul M, Khalid A. Correlation between Serum Electrolytes and Fasting Glucose and Hb1Ac in Saudi Diabetic Patients. Biol. Trace. Elem. Res. 2011;144:463-8.

Shahid SM, Rafique R, Mahboob T. Electrolytes and sodium transport mechanism in diabetes mellitus. Pak. J Pharm. Sci. 2005;18(2):6-10.

Lobo DN. Fluid, electrolytes and nutrition: physiological and clinical aspects. Proc. Nutr. Soc. 2004;63(3):453-6.

Kamel SK, Halperin ML. Acid–Base Problems in Diabetic Ketoacidosis. In: Julie R. Ingelfinger, M.D. Disorders of Fluids and Electrolytes, N Engl J Med. 2015;372:546-54.