Electrolytic Disturbances Among Diabetic Patients Admitted in a Tertiary Care Hospital

Type 2 diabetes mellitus is a widely prevalent lifestyle disease associated with high morbidity and mortality due to dead end complications like acute coronary syndrome, chronic kidney failure and acute stroke. Diabetes mellitus patients frequently develop problems of dyselectrolytemia which is common among hospitalised patients with decompensated diabetes. But there is little information on the prevalence of electrolyte disturbances among diabetes patients. Electrolytes are crucial in maintaining various metabolic functions and play a pivotal role in maintaining a healthy state's body. Diabetic patients are more prone to and frequently develop a constellation of electrolyte disorders due to hyperglycaemia, polydipsia and polyuria. 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. 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 student's t-test was used to compare mean values between patients and controls, while the chi square test was used to assess for differences between categorical variables. The significance level was set at 5%. Glucose, K+, Na+ and Cl- were determined in fasting blood samples. The proportions of subjects with abnormal values in the diabetic population and in the control group were compared using Chi-square test. Results: A total of 100 subjects participated in the study, of which 50 had uncontrolled DM and 50patients with controlled diabetes. 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. Conclusions: T2D was found to promote electrolyte imbalance particularly potassium ion derangement and may affect renal function. Risk factors of T2D such as old age and high blood pressure may also promote electrolyte disorders. 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.