Opposite Changes in Serum Sodium and Potassium in Patients in Diabetic Coma.

Ishikawa, San‐e; Sakuma, Nobuko; Fujisawa, Genro; Tsuboi, Yasushi; Okada, Koji; Saito, Toshikazu

doi:10.1507/endocrj.41.37

Cited by 10 publications

(9 citation statements)

References 15 publications

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“…After plasma glucose levels were well controlled, serum Na and K levels reached the normal ranges in all the four groups of patients. In addition, exceptional distribution, namely hypernatremia and hypokalemia, were observed in two patients with non-ketotic hyperosmolar coma, as described previously in our report [6]. [12,13].…”

Section: Methodssupporting

confidence: 82%

“…HYPONATREMIA was described in patients with diabetic coma, and serum sodium (Na) levels have been reported to decrease at the rate of 1.6 mEq/l per 100 mg/dl increase in plasma glucose [1][2][3][4][5]. In our previous study, we analyzed 26 patients with diabetic coma, who had noticeable hyperglycemia associated with serious dehydration [6]. There were opposite changes in serum Na and potassium (K) levels, namely hyponatremia with hyperkalemia, and hypernatremia with hypokalemia [6].…”

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confidence: 99%

“…In our previous study, we analyzed 26 patients with diabetic coma, who had noticeable hyperglycemia associated with serious dehydration [6]. There were opposite changes in serum Na and potassium (K) levels, namely hyponatremia with hyperkalemia, and hypernatremia with hypokalemia [6]. The alterations in serum Na and K levels were closely linked with one another, suggesting that hyperosmolality was not the sole cause of the change [6].…”

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confidence: 99%

“…There were opposite changes in serum Na and potassium (K) levels, namely hyponatremia with hyperkalemia, and hypernatremia with hypokalemia [6]. The alterations in serum Na and K levels were closely linked with one another, suggesting that hyperosmolality was not the sole cause of the change [6]. Such a volume-depleted state increases plasma arginine vasopressin, plasma renin activity and plasma aldosterone concentration in diabetic coma [7,8].…”

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confidence: 99%

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Inverse Distribution of Serum Sodium and Potassium in Uncontrolled Inpatients with Diabetes Mellitus.

Saitô¹,

Ishikawa²,

Higashiyama³

et al. 1999

Endocr J

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Abstract.It has been reported that there is an inverse relationship between serum sodium (Na) and potassium (K) levels in patients with diabetic coma. The present study was undertaken to determine whether such an inverse relation depends upon plasma glucose levels in diabetic patients for their glycemic control. We examined two hundred and fifty-two patients with diabetes mellitus admitted to our hospital during the one-year period to control their plasma glucose levels, except for those having nephropathy or liver dysfunction. Serum Na and K, plasma glucose, and serum and urinary C-peptide levels were determined.There was a negative correlation between serum Na levels and fasting plasma glucose (FPG), and, conversely, a positive correlation between serum K levels and FPG. The changes were more evident in the patients with insulin-dependent diabetes mellitus than those with non-insulindependent diabetes mellitus.There was an inverse relation between serum Na and K levels and it was profoundly dependent upon plasma glucose levels in all the diabetic patients before tight control of their glycemic levels. The disorder may be based on the movement of electrolytes between intra-and extracellular spaces, dependent on the impaired insulin action as well as hyperosmolality.

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Section: Methodssupporting

confidence: 82%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Inverse Distribution of Serum Sodium and Potassium in Uncontrolled Inpatients with Diabetes Mellitus.

Saitô¹,

Ishikawa²,

Higashiyama³

et al. 1999

Endocr J

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“…This is surprising because previous reports from Japan indicated an inverse relationship between serum sodium and potassium in DKA (27,28).…”

Section: Discussionmentioning

confidence: 69%

Prevalence of abnormal serum sodium and potassium concentration in paediatric new onset type 1 diabetes with ketoacidosis: A retrospective study from two Nigerian Teaching Hospitals

Onyiriuka

Oyenusi

2018

Sri Lanka J. Diabetes Endocrinol. Metab.

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Background/Aim: Community-acquired electrolyte disorders have been associated with poor prognosis following hospitalization and treatment for various illnesses. The aim of the study was to estimate the prevalence of abnormalities of serum sodium and potassium concentrations in patients with new-onset type 1 diabetes with ketoacidosis at presentation in the paediatric emergency departments of two Nigerian teaching hospitals. Method:A retrospective medical records review was performed on all paediatric patients with new-onset type 1 diabetes complicated by ketoacidosis seen in two Nigerian hospitals (University of Benin Teaching Hospital and Lagos University Teaching Hospital) over a period of 5 years. Information obtained included age at diagnosis, gender, presenting complaints and outcome (dead or alive). Data on serum electrolyte concentrations (sodium, potassium, chloride, bicarbonate) as well as blood glucose before initiation of fluid resuscitation and insulin therapy were extracted. The anion gap and effective osmolality were computed.Results: Overall, 25(53.2%; 95% Confidence interval, CI= 38.9-67.5) of the 47 patients had abnormalities in serum sodium, potassium or a combination of both. With regard to serum sodium, isolated abnormalities were found in 14(29.8%; 95% CI =16.7-42.9) of 47 patients. Hyponatremia occurred in 25.5% (95% CI=19.1-31.9) and hypernatremia occurred in 2.1% (95% CI = 0.01-4.2). Of the 47 patients, 10(21.3%; 95% CI =15.3-27.3) had isolated serum potassium abnormalities. The frequency of hypokalemia and hyperkaliemia were 8.5% (95% CI= 4.4-12.6) and 10.6%(95% CI= 6.6-15.1), respectively. The hypokalemia was severe (< 2.5mmol/L) in 2.1% of cases. The frequency of combined hyponatremia and hypokalemia was 2.1%. The mean anion gap was 18.6±0.6 (95% CI =18.4-18.8). The mean time for resolution of ketoacidosis was 2.8±0.6 days (95% CI= 2.6-3.0). Five (10.9%) of the 47 patients were toddlers (1 to 3 years old). Polyuria, weakness and anorexia were the key presenting complaints in toddlers with DKA. Of the 28 patients from UBTH, one (3.4%) died and the patient had severe mixed electrolyte disturbances (hyponatremia, hypokalemia and acidosis). Conclusion:At point of hospitalization for paediatric new-onset diabetes with ketoacidosis, disturbances in serum sodium and potassium concentrations were common. Polyuria, weakness and anorexia were the key presenting complaints in toddlers with DKA.

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The fulminant index: A method of rapidly differentiating fulminant type 1 diabetes from diabetic ketoacidosis

Qiu

Chen

et al. 2021

Diabetes Metabolism Res

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Department of Endocrinology,the ninth a liated hospital of guangxi medical university Xia Li department of metabolism and endocrinology,th second xiangya hospital,central south university Wen Chen department of endocrinology,the ninth a liated hospital of guangxi medical university Xiaoxi Ma department of metabolism and endocrinology, the second xiangya medical hospital, central south university Zhiguo Xie department of metabolism and endocrinology,the second xiangya hospital,central south university Gan Huang department of metabolism and endocrinology,the second xiangya hospital,central south university Shuoming Luo department of metabolism and endocrinology, the second xiangya hospital,central south university Zhiguang Zhou ( 

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Opposite Changes in Serum Sodium and Potassium in Patients in Diabetic Coma.

Cited by 10 publications

References 15 publications

Inverse Distribution of Serum Sodium and Potassium in Uncontrolled Inpatients with Diabetes Mellitus.

Inverse Distribution of Serum Sodium and Potassium in Uncontrolled Inpatients with Diabetes Mellitus.

Prevalence of abnormal serum sodium and potassium concentration in paediatric new onset type 1 diabetes with ketoacidosis: A retrospective study from two Nigerian Teaching Hospitals

The fulminant index: A method of rapidly differentiating fulminant type 1 diabetes from diabetic ketoacidosis

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