Electrolyte Disturbances among Diabetic Patients Admitted in a Multi-specialty Hospital in Southern India

Abstract

Introduction: Diabetes mellitus (DM) is one of the most common non-communicable diseases associated with high morbidity and mortality. Electrolyte disturbances are not uncommon among in-hospital patients with DM. However, there are limited data on the magnitude of electrolyte disturbances in the diabetic population. Aim: To identify the common electrolyte disturbances among diabetic in-patients and to determine if there is an association of blood sugar control with electrolyte disturbances. Materials and Methods: A cross-sectional study was performed among patients admitted with a diagnosis of diabetes and without any restriction of any concomitant illness. Fasting, post prandial blood glucose, HbA1c, serum sodium, potassium, chloride, urea and creatinine were measured. The frequency of electrolyte disturbances was compared between those patients with well controlled vs. inadequately controlled blood sugar. Results: A total of 342 subjects participated in the study, of which 195 (57%) had uncontrolled DM. The frequency of hyponatremia, hypokalemia, hyperkalemia, hypochloremia and hyperchloremia was 33%, 16%, 6%, 31% and 2.7% respectively. In diabetic patients, hyponatremia was seen more commonly in patients with uncontrolled DM than those with well controlled blood sugars (38.46 vs 27.73%, p=0.01). Hypochloremia was more common among subjects with uncontrolled DM (23.65% vs 17.55%, p=0.01). The proportion of patients with hypokalemia or hyperkalemia did not differ between the two groups. Patients on insulin therapy were more likely to have hyponatremia than non-insulin users (p=0.01). Conclusion: Diabetic patients have an increased predilection to develop electrolyte disturbances. The most common electrolyte disturbance seen was hyponatremia and hypochloremia and they were widely prevalent among patients with uncontrolled DM.

Keywords

• dyselectrolytemia
• hypochloremia
• hypokalemia
• hyponatermia
• uncontrolled blood sugar