Acid-base and electrolyte disturbances in patients with diabetes mellitus

2018 ◽  
Vol 74 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Lissa Pipeleers ◽  
Karl Martin Wissing ◽  
Robert Hilbrands
Author(s):  
N.S. Alkhateeb, ◽  
◽  
M.A. Frolov ◽  
V.V. Shklyaruk ◽  
K.N. Odinaeva ◽  
...  

The number of patients with diabetes mellitus in the Russian Federation on January 1, 2019 is more than 4.5 million people, which is 3.12% of the population of the Russian Federation. Metabolic disorders in diabetes mellitus cause physicochemical changes, including a violation of acid-base balance (pH). Aim. To study the effect of diabetes mellitus and ocular prosthetics on the acid-base balance of the prosthetic cavity. Materials and methods. From 2018 to 2021 - 185 patients of both sexes from 21 to 80 years old (57.73±17.34 years old) were examined. 47 patients using an eye prosthesis and without diabetes mellitus (group I); 93 patients using an eye prosthesis with diabetes (group II), which were divided into two subgroups depending on the level of glycated hemoglobin (HbA1c): II-a subgroup - 47 patients with HbA1c up to 7.5%, II-b group – 46 patients with HbA1c more than 7.5%; 45 patients, without an eye prosthesis and without diabetes mellitus (group III). Results. In patients with an ocular prosthesis and without diabetes, a shift in pH to the side of acidosis was observed. In patients with an ocular prosthesis and with diabetes mellitus, the greatest shift in the pH of the conjunctival cavity to the side of acidosis, depending on the level of HbA1c (8-8.5 – in 25.8% of cases, 9-9.5 – in 43% of cases, and <10 – in 31.2% of cases). Conclusions. The presence of an ocular prosthesis in the conjunctival cavity leads to a shift in pH to the side of the alkaline side. The progression of the pH shift to the side of acidosis directly depends on the HbA1c level in patients, and the combination of two factors (the use of an ocular prosthesis in the conjunctival cavity and the presence of diabetes in the anamnesis) leads to an aggressive shift in the pH of the conjunctival cavity to the side of acidosis. Key words: acid-base balance, ocular prosthesis, diabetes mellitus.


Author(s):  
Raveendra K. R. ◽  
Avinash H. R. ◽  
Nitish Ashok Gurav

Background: Acute kidney injury is a common problem with various causes and consequences like electrolyte disturbances in the form of hypocalcaemia, hypokalemia, hyperkalemia depending on the phase. Hypomagnesaemia is one of the most common electrolyte disturbance found in hospitalized patients especially in the critically ill patients. Prevalence of hypomagnesemia varies from 11 to 65% in different studies. Hence, we decided to conduct a study to evaluate correlation of serum magnesium levels in AKI.Methods: A cross-sectional, hospital based time bound study was conducted between November 2016 and August 2018 with a sample of 100 patients aged 18-65 years and who had AKI were included and patients with diabetes mellitus, multi-organ dysfunction, obstructive uropathy and drug induced AKI were excluded from study. The decrease in magnesium <1.7 mg/L was defined as hypomagnesaemia. AKI was defined as per AKIN criteria. Day 1, day 3 and day 6 magnesium levels were measured.Results: Prevalence of hypomagnesaemia was 53%, 30% and 36% on day 1, day 3 and day 6 respectively. It was observed that there was a positive correlation between serum magnesium, and serum creatinine. Normomagnsemia and hypermagnesemia on day 1, 3 and 6 were significantly associated with recovery of AKI (p<0.001).Conclusions: The prevalence of hypomagnesemia was significantly higher in AKI patients and normal magnesium and hypermagnesium on day 1, 3 and day 6 was associated with recovery than non-recovery. Hypomagnesemia was associated more with non-recovery then recovery.


2018 ◽  
Vol 10 (1) ◽  
pp. 27-35
Author(s):  
S Khanduker ◽  
R Ahmed ◽  
F Khondker ◽  
A Aharama ◽  
N Afrose ◽  
...  

Diabetic patients frequently develop a constellation of electrolyte disorders. These derangement results from insulin deficiency, hyperglycemia and hyperketonemia. Hyperglycemia sets the internal environment for osmotic diuresis while causing a dilutional effect on electrolyte concentrations.The osmotic effect of glucose results in decreased circulating blood volume and fluid shift from the intracellular spaces causing cellular dehydration. These disturbances are particularly common in decompensated diabetes, especially in the context of diabetic ketoacidosis or non ketotic hyperglycemic hyperosmolar syndrome.These patients are markedly sodium, magnesium and phosphate depleted. Diabetes mellitus is linked to both hypo and hyperkalemia and also hypo and hypercalcemia reflecting coexistence of hyperglycemia related mechanisms, which tend to change serum potassium and calcium to opposite directions. This article provides an overview of the electrolyte disturbances occurring in Diabetes and mechanisms underlying those disturbances.Bangladesh J Med Biochem 2017; 10(1): 27-35


Author(s):  
Bruce R. Pachter

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).


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