Factors Precipitating Hypokalemia in Diabetic Patients: A Cross Sectional Study

Ahmed, Sheikh Salahuddin; Nur, Fazle; Ullah, Rahamat; Mamun, Abdullah Al; Khan, Aminul Haque

doi:10.3329/jemc.v4i3.20940

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…Other studies also identified abnormally low serum level of potassium in diabetic patients. 2,3,16,26,28,[32][33][34][35] The main reason for the abnormal level of potassium may be related to insulin treatment. When insulin is administered and glucose is taken up by the cells, potassium passes through the cell membrane along with glucose, decreasing the concentration of potassium both in blood and intracellular fluid.…”

Section: Discussionmentioning

confidence: 99%

<p>Assessment of Selected Serum Electrolyte and Associated Risk Factors in Diabetic Patients</p>

Woyesa¹,

Gebisa²,

Anshebo³

2020

DMSO

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The objective of this study was to assess selected serum electrolytes imbalance and associated factors in diabetic patients attending their follow up appointments in Jimma University Medical Center (JUMC) from February 1 to April 1, 2019. Patients and methods: A cross sectional study design was used to assess the selected serum electrolytes in diabetic patients attending their follow up appointments at Jimma University Medical Center (JUMC) chronic illness clinic. A convenience sampling technique was used to include 279 diabetic patients in the study and an interviewer based questionnaire was used to include all necessary data from each diabetic patient. Five milliliters of blood were collected from each subject and processed and analyzed for blood glucose and serum electrolyte determination by ABX Pentra400 and Humalyte plus 5 ion-selective electrode (ISE) system clinical chemistry analyzers. Pearson's correlation coefficient model and multivariate logistic regression were used respectively to assess the correlation and significant association between abnormal serum electrolytes and independent variables. Results: A high prevalence of one or more serum electrolyte abnormalities was determined in diabetic patients. The overall prevalence was 42.0% (n=116/276) in which hyponatremia was the highest followed by hypochloremia and hypercalcemia, 40.6%, 14.9% and 10.9% respectively. Age, type of medication, and high body mass index (BMI) had strong positive correlations with abnormal serum concentration levels of sodium (r=0.611, P=0.731), potassium (r=0.752, P=0.812) and chloride (r=0.645, P=0.459). Being employed (AOR: 3.933, 95% C.I: 1.057-14.637, P value: 0.041), treated with mixed medications (AOR: 2.9, 95% C.I: 1.292-6.441, P value: 0.010) and being unable to control blood glucose level or being hyperglycemic (AOR: 3.2, 95% C.I: 2.179-5.721, P value: 0.000) were statistically identified as risk factors for serum electrolyte abnormalities in diabetic patients. Conclusion:The serum electrolyte concentration level was highly abnormal in diabetic patients. The prevalence of abnormal concentration was more common in diabetic patients with advanced age, and some variables had strong positive correlation with abnormal serum electrolyte level in diabetic patients.

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Section: Discussionmentioning

confidence: 99%

<p>Assessment of Selected Serum Electrolyte and Associated Risk Factors in Diabetic Patients</p>

Woyesa¹,

Gebisa²,

Anshebo³

2020

DMSO

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“…Changes in intracellular Mg 2+ concentration can lead to hypokalemia in diabetics, and insulin therapy can also promote the K + shift into cells. 37 On the other hand, hyperglycemia causes a redistribution of K + from the intracellular to extracellular fluid compartment due to factors that impair cellular uptake, leading to hyperkalemia. 27 Our funding is greater than the prevalence of hypophosphatemia in Jordan (10%), 11 as well as hypokalemia and hyperkalemia in Thailand (6.7% and 2.9%), respectively.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Electrolyte Imbalance and Associated Factors Among Adult Diabetic Patients Attending the University of Gondar Comprehensive Specialized Hospital, Ethiopia: A Comparative Cross-Sectional Study

Eshetu¹,

Worede²,

Fentie³

et al. 2023

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Introduction: Electrolyte imbalance refers to altered electrolyte levels that predominantly affect diabetic patients due to hyperglycemia which rise plasma osmolality and impaired renal function, contributing to a change in electrolyte level. Therefore, this study aimed to assess the prevalence of electrolyte imbalance and its associated factors among diabetic patients and healthy control groups attending the University of Gondar Comprehensive Specialized Hospital. Patients and Methods: A comparative cross-sectional study was conducted on 130 diabetic patients and 130 diabetes-free controls. Sociodemographic, behavioral and clinical data were collected using a structured questionnaire. After measuring anthropometric parameters, 5mL of the blood sample was collected. Electrolytes were measured based on ion-selective electrode methods. Fasting blood glucose, and creatinine were measured by spectrophotometric enzyme hexokinase, and Jaffe reaction methods, respectively. The data was entered into Epi-data version 4.6 and analyzed using STATA version 14. Mann-Whitney U-tests and independent t-tests were used for comparison. Multiple logistic regression analysis was done to determine the factors associated with electrolyte imbalances. P-value <0.05 was considered statistically significant. Result: The overall prevalence of electrolyte imbalance among diabetic patients and controls were 83.07% and 52.31%, respectively. The mean of Na + and the median level of Mg 2+ and Ca 2+ were significantly decreased. However, the mean level of Cl − was significantly increased in diabetic patients as compared to control groups. In multivariable logistic regression: alcohol consumption AOR = 3.34 [1.02-10.9], no formal education ], hyperglycemia AOR = 6.32 [2.04-19.5], and urbanization ] showed significant association with electrolyte imbalance. Conclusion: Diabetic patients have more likely to develop electrolyte imbalance than control groups. Diabetic participants showed significantly reduced Na + , Mg 2+ , and Ca 2+ levels and significantly increasing CI − levels when compared to control groups. Hyperglycemia, alcohol drinking habits, urbanization, and no-formal education were statistically significantly associated with electrolyte imbalance.

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“…The excessive use of insulin is associated with hypoK. On another hand, drugs like thiazide or loop diuretics, used for treating comorbid conditions like hypertension in diabetes, may also cause hypoK [36]. It is to be assumed that the correction of the hyperglycemia, as well as the suspension of these drugs during the hospitalization, would correct the hypoK.…”

Section: Discussionmentioning

confidence: 99%

Serum Potassium Trajectory during Acute Kidney Injury and Mortality Risk

Chávez-Íñiguez¹,

Maggiani-Aguilera²,

Quevedo³

et al. 2023

Nephron

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Background: The association between potassium (sK) level trajectory and mortality or the need for kidney replacement therapy (KRT) during acute kidney injury (AKI) has not been adequately explored. Methods: In this prospective cohort, AKI patients admitted to the Hospital Civil de Guadalajara were enrolled. Eight groups based on the sK (mEq/L) level trajectories during 10 days of hospitalization were created, (1) normokalemia (normoK), defined as sK between 3.5-5.5; (2) hyperkalemia to normoK; (3) hypokalemia to normoK; (4) fluctuating potassium; (5) persistent hypoK; (6) normoK to hypoK; (7) normoK to hyperK; (8) persistent hyperK. We assessed the association of sK trajectories with mortality and the need for KRT. Results: A total of 311 AKI patients were included. The mean age 52.6 years, and 58.6% were male. AKI stage 3 was present in 63.9%. KRT started in 36% patients, and 21.2% died. After adjusting for confounders, 10-day hospital mortality was significantly higher in group 7 and 8 (OR, 1.35 and 1.61, p = <0.05, for both, respectively), and KRT initiation was higher only in group 8 (OR 1.38, p = < 0.05) compared with group 1. Mortality in different subgroups of patients in group 8 did not change the primary results. Conclusion: In our prospective cohort, most patients with AKI had alterations in sK+. NormoK to hyperK and persistent hyperK were associated with death, while only persistent hyperK was correlated with the need for KRT.

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Factors Precipitating Hypokalemia in Diabetic Patients: A Cross Sectional Study

Cited by 4 publications

References 24 publications

<p>Assessment of Selected Serum Electrolyte and Associated Risk Factors in Diabetic Patients</p>

<p>Assessment of Selected Serum Electrolyte and Associated Risk Factors in Diabetic Patients</p>

Assessment of Electrolyte Imbalance and Associated Factors Among Adult Diabetic Patients Attending the University of Gondar Comprehensive Specialized Hospital, Ethiopia: A Comparative Cross-Sectional Study

Serum Potassium Trajectory during Acute Kidney Injury and Mortality Risk

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