Pattern of Electrolyte Imbalance in Hospitalized Diabetic Patients: Experience in a Tertiary Care Hospital

Haque, Hasna Fahmima; Amin, Mohammad Al; Uddin, Khwaja Nazim; Ahmed, Jamal Uddin; Ahmed, Akm Shaheen; Rahim, Muhammad Abdur; Dewan, Pratik; Samad, Tabassum

doi:10.3329/birdem.v2i1.12355

Cited by 7 publications

(16 citation statements)

References 17 publications

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“…It was 61% in a study conducted in Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM). 28 The most common precipitating factor for hypokalemia found in our study was vomiting (63.2%). In addition to gastrointestinal loss by vomiting there is also excess renal K + loss due to metabolic alkalosis following chloride loss secondary to vomiting.…”

Section: Discussionsupporting

confidence: 45%

Factors Precipitating Hypokalemia in Diabetic Patients: A Cross Sectional Study

Ahmed

Nur²,

Ullah

et al. 2014

J Enam Med Col

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Section: Discussionsupporting

confidence: 45%

Factors Precipitating Hypokalemia in Diabetic Patients: A Cross Sectional Study

Ahmed

Nur²,

Ullah

et al. 2014

J Enam Med Col

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“…This cross sectional study showed that hyponatremia was the most common (63.3%) type of EI in admitted diabetic patients. It was found to be 80% in a study conducted in one of the largest hospital of Bangladesh mainly for diabetes care named Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) 19 . Other studies have also shown that hyponatremia is common in hospitalized patients and is responsible for increased morbidity and mortality [20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

“…Most of the patients in our study had multiple co-morbid conditions of which hypertension was the most common (66%). It was found to be 61% by a study conducted in BIRDEM 19 . Another study also revealed hypertension to be the most common (69%) comorbid condition in patients with hyponatremia 26 .…”

Section: Precipitating Factorsmentioning

confidence: 95%

“…It was found to be 51 % by a study conducted in BIRDEM 19 . The next common cause of EI in our study was found to be diarrhea (23.3%).…”

Section: Precipitating Factorsmentioning

confidence: 95%

“…But we also face electrolyte disturbances routinely in our clinical practice so EI should also be considered as an important complication especially in the diabetic patients admitted in hospital. Therefore serum electrolytes should be checked routinely in hospitalized diabetic patients irrespective of their purpose of admission 19 . Every patient needs thorough evaluation and assessment for etiology & precipitating factors responsible for EI and therefore rational measures taken for their management.…”

Section: Rationalementioning

confidence: 99%

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Electrolyte Imbalance in Admitted Diabetic Patients: Patterns and Factors Responsible- A Cross Sectional Study

Ahmed

Nur²,

Ullah

et al. 2017

KYAMC j.

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Diabetes Mellitus (DM) is a major burden upon health-care facilities in all countries. Electrolyte imbalances (EI) are very common in admitted patients with diabetes which leads to substantial morbidity and mortality. Every patient with diabetes needs thorough evaluation for the etiology and precipitating factors responsible for EI and therefore rational management. Data regarding the incidence of EI in DM in our country is limited. There is no existing record for profiling of EI in Bangladeshi diabetic subjects. The objective of this study was to find out the common types of EI in hospitalized diabetic patients and to determine the influencing factors responsible for them. Samples were selected from all adult nonpregnant diabetic patients admitted in the indoor, department of Medicine with electrolyte disturbances irrespective of their cause of admission. A total number of 150 admitted diabetic patients with electrolyte imbalance were interviewed, examined physically and laboratory specimen taken for biochemical analysis. Information was collected in a semi structured data collection form for analysis. Hyponatremia was found to be the most common EI in admitted diabetic patients. Electrolyte imbalance was found to be more common in the aged and female populations. Common factors influencing EI were vomiting, diarrhea, sweating, uncontrolled diabetes with severe hyperglycemia and certain drugs especially diuretics. Among the other well established complications of diabetes like acute metabolic complications, microangiopathy and macroangiopathy, EI should also be considered especially in the admitted patients.KYAMC Journal Vol. 5, No.-1, Jul 2014, Page 458-466

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Pattern of Electrolytes Including Calcium and Magnesium Imbalance with Etiology Assessment in Patients Admitted in Endocrine Department of a Tertiary Care Hospital

Rahman¹,

Barua²,

Huq³

et al. 2020

IJDE

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Objectives: Several endocrine disorders have marked effects on fluid, electrolyte, and acid-base homeostasis including diabetic ketoacidosis, hyperglycemic hyperosmolar state, and acute adrenal crisis etc. An understanding of the etiology behind the development of these electrolytes along with calcium and magnesium imbalance helps to guide therapy and improves the clinical outcome. The aim of this study to see the pattern of electrolytes, calcium and magnesium imbalance with etiology assessment in patients admitted in endocrine department of a tertiary care hospital. Study design and methods: This cross sectional observational study was carried out from January 2018 to December 2018, at in-patient department of Endocrinology, BIRDEM General Hospital, Dhaka. Diagnosed (old and new) cases of diabetic and other endocrine disorders having electrolytes, calcium and magnesium imbalance were approached for sinclusion of the study. Sampling technique was purposively selected focusing on demographic profile and diagnosis of the disease. Results: Among the 100 participants, mean age of the study population was 46.26±16.97 years, ranging from 14 to 75 years. There were 50%-male and 50%-female. In result the most common electrolyte imbalance was hyponatremia (36%) that was more in type-2 DM patients (n=25) then in Addison's disease (n=4) and rest are in other specific form of DM (n=3), type-1 DM (n=2), DM with hypoparathyroidism (n=1) and hypoparathyroidism (n=1) which may be due to SIADH. Followed by hypokalemia (14%) which mostly encountered in type-2 DM patient (n=6) due to diuretics and in Conn's syndrome (n=4), hyperkalemia (10%) which mostly observed in type-1 DM patient (n=4) due to DKA, and hypercalcemia (8%) was found in non-diabetic endocrine disorders. Hypernatremia, hypocalcemia and hypomagnesemia were present in 7%, in 6%, and 6% cases, respectively. The most common precipitating cause of these electrolyte imbalances was vomiting (30%) due to different causes like urinary tract infection; acute gastritis and pancreatitis. Diuretic (Loop & Thiazide) therapy (10%) and HHS (8%) were the second and third most common cause behind these electrolytes imbalance Conclusion: In conclusion data obtained in this study showed hyponatremia was the most common findings which more observed in diabetic patients. As vomiting is the most common cause behind this so any diabetic patients either present with vomiting or any other illness should routinely advice electrolytes along with magnesium as hypomagnesemia also more observed in this group. To find out the cause of hypokalemia in non-diabetic patients should evaluate the Conn's syndrome and don't forget to measure the parathyroid hormone in hypercalcemic patient. Further study is needed to find out the causes of vomiting.

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Pattern of Electrolyte Imbalance in Hospitalized Diabetic Patients: Experience in a Tertiary Care Hospital

Cited by 7 publications

References 17 publications

Factors Precipitating Hypokalemia in Diabetic Patients: A Cross Sectional Study

Factors Precipitating Hypokalemia in Diabetic Patients: A Cross Sectional Study

Electrolyte Imbalance in Admitted Diabetic Patients: Patterns and Factors Responsible- A Cross Sectional Study

Pattern of Electrolytes Including Calcium and Magnesium Imbalance with Etiology Assessment in Patients Admitted in Endocrine Department of a Tertiary Care Hospital

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