Serum electrolyte levels in Libyan patients with type II diabetes mellitus

Abstract :

The incidence of diabetes mellitus has increased globally making it a major public health concern. Diabetes mellitus is the most common metabolic disorder that causes an imbalance in the electrolytes which regulate essential metabolic mechanisms of the body. This study aimed to estimate the electrolyte levels in Libyan patients with type II diabetes mellitus and to investigate their relations to glycemic control and body mass index. A total of 122 Libyan subjects whose ages ranged between 35 years and 60 years for both sexes were included in this study, 77 patients were type II diabetic patients (37 males and 40 females) and 45 subjects were healthy individuals (23 males and 22 females) live in Tripoli area, Libya. The levels of blood glucose, HbA1c, sodium, potassium, chloride, magnesium and calcium were estimated in this study along with the measurement of body mass index, systolic and diastolic blood pressure. All the findings were statistically analyzed by one-way ANOVA test. Significant increases in glucose, HbA1c, potassium, chloride, calcium, blood pressure and BMI among diabetic patients were observed as compared to the healthy individuals. On the other hand, significant decreases in sodium and magnesium levels among the diabetic patients were observed as compared to the control group. In addition, significant alterations in all the biochemical parameters in uncontrolled diabetic patients as compared to the controlled diabetic patients, and in unhealthy weight diabetic patients as compared to the healthy weight patients. It is concluded that diabetes mellitus results in an imbalance of electrolytes. Poor glycemic control and obesity have adverse effects on electrolyte balance among diabetic Libyan patients. Good glycemic control, maintaining a healthy weight and regular evaluation of electrolytes among diabetics can reduce the fatalities associated with electrolyte rearrangements.

References

1. Kitabchi AE, Umpierre GE, Murphy MB, Kriesberg RA (2006) Hyperglycemic crisis in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 29 (12): 2739-2748. doi: 10.2337/dc06-9916
2. Shetty R, Mohandas R, Chandrashekar R, Kalal BS (2020) Diabetogenic effect of gluten in Wistar albino rats: a preliminary preclinical screening. Medicine and Pharmacy Report. 93 (1): 47-52. doi: 10.15386/MPR-1373
3. International Diabetes Federation. IDF Diabetes Atlas (2019) Ninth edition 2019. Brussels, Belgium: International Diabetes Federation. ISBN: 978-2-930229-87-4
4. Balci AK, Koksal O, Kose A, Armagan E, Ozdemir F, Inal T, Oner N (2013) General characteristics of patients with electrolyte imbalance admitted to emergency department. World Journal of Emergency Medicine. 4 (2): 113-116. doi.org/10.5847/wjem.j.1920 -8642.02.005
5. Totan AR, Greabu M (2002) Effect of chronic hyperglycemia and vanadate treatment on erythrocyte Na/K-ATPase and Mg-ATPase in streptozotocin diabetic rats. Acta Poloniae Pharmaceutica. 59 (4): 307-311. PMID: 12403306
6. Shahid SM, Rafique R, Mahboob T (2005) Electrolytes and sodium transport mechanism in diabetes mellitus. Pakistan Journal of Pharmaceutical Sciences.18 (2): 06-10. PMID: 16431390
7. Hasona NA, Elasbali A (2016) Evaluation of electrolytes imbalance and dyslipidemia in diabetic patients. Medical Sciences (Basel). 4 (2): 7. doi.org/10.3390/medsci4020007
8. Kalal BS, Pai VR, Behera SK, Somashekarappa HM (2019) Hdac2 inhibitor valproic acid increases radiation sensitivity of drug-resistant melanoma cells. Medical Sciences. 7 (3): 51. doi.org/10.3390/medsci 7030051
9. Thaman R, Arora GP (2013) Metabolic syndrome: definition and pathophysiology - the discussion goes on. Journal of Physiology and Pharmacology Advances. 3: 48-56. doi:10.5455/jppa.20130317071355
10. Goldberg A, Hammerman H, Petcherski S, Zdorovyak A, Yalonetsky S, Kapeliovick M, Agmon Y, Markiewicz W (2004) Prognostic importance of hyponatremia in acute ST-elevation myocardial infarction. The American Journal of Medicine. 117 (4): 242-248. doi.org/10.1016/j.amjmed. 03.022
11. Liamis G, Liberopoulos E, Barkas F, Elisaf M (2014) Diabetes mellitus and electrolyte disorders. World Journal of Clinical Cases. 2 (10): 488-496. doi: 10.12998/wjcc.v2.i10.488
12. Datchinamoorthi S, Vanja R, Rajagopalan B (2016) Evaluation of serum electrolytes in type II diabetes mellitus. International Journal of Pharmaceutical Sciences Review and Research. 40 (1): 251-253.
13. Hofmann W (2012) The pitfall dehydration and hyponatremia. Zeitschrift für Gerontologie und Geriatrie. 45 (2): 155-63. doi: 10.1007/s00391-011-0284-0
14. Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J, Li Y, Wang X, Zhao L (2018) Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 9 (6): 7204-7218. doi: 10.18632/oncotarget.23208
15. Al-Lawati JA (2017) Diabetes mellitus: a local and global public health emergency. Oman Medical Journal. 32 (3): 177-179. doi.org/10.5001/omj.2017.34
16. Kitabchi AE, Umpierrez GE, Murphy MB, Kriesberg RA (2006) Hyperglycemic crisis in adult patients with diabetes: A consensus statement from the American Diabetes Association. Diabetes Care. 29 (12): 2739-2748. doi: 10.2337/dc06-9916
17. Hoorn EJ, Zietse R (2017) Diagnosis and treatment of hyponatremia: compilation of the guidelines. Journal of the American Society of Nephrology. l28 (5): 1340-1349. doi: 10.1681/ASN.2016101139
18. Girndt M (2011) Electrolyte disorders. Internist (Berl). 52 (8): 963-974. doi: 10.1007/s00108-011-2819-2
19. Chansky M, Haddad G (2008) Acute diabetic emergencies, hypoglycemia, and glycemic control. Critical Care Medicine. 1245-1267. doi: 10.1016/B978-032304841-5.50061-3
20. Burtis CA, Ashwood ER, Bruns DE (2013) Tietz textbook of clinical chemistry and molecular diagnosis (5th edition). Elsevier, St. Louis, USA. Р. 909. Indian Journal of Clinical Biochemistry. 28 (1): 104-105. doi: 10.1007/s12291-012-0287-7
21. Wang S, Hou X, Liu Y, Lu H, Wei L, Bao Y, Jia W (2013) Serum electrolyte levels in relation to macrovascular complications in Chinese patients with diabetes mellitus. Cardiovascular Diabetology. 12 (146): 1-10. doi: 10.1186/1475-2840-12-146.
22. Das A, Borkotoko S (2016) Evaluation of serum electrolyte levels in type 2 diabetes mellitus. Indian Journal of Applied Research. 6 (8): 91-93.
23. Holkar S, Vaishnav D, Hivre M (2014) Study of serum electrolytes levels in patients with diabetic ketoacidosis. International Journal of Health Sciences and Research. 4 (9): 154-157. Corpus ID: 53835942
24. Deepti GN, Sumina C, Lakshmi K (2017) A comparative study of electrolyte imbalances in controlled and uncontrolled diabetes mellitus. International Journal of Clinical Biochemistry and Research. 4 (1): 22-24.
25. Palmer BF, Clegg DJ (2015) Electrolyte and acid-base disturbances in patient with diabetes mellitus. The New England Journal of Medicine. 373 (6): 548-559. doi: 10.1056/NEJMra1503102
26. Tuck ML, Sambhi MP, Levin L (1979) hyporeninism and hypoaldosteronism in diabetes mellitus: Studies of the autonomic nervous system's control of renin release. Diabetes. 28 (3): 237-241. doi: 10.2337/diab.28.3.237
27. Rajagambeeram R, Malik I, Vijayam M, Gopal N, Ranganadin P (2020) Evaluation of serum electrolytes and their relation to glycemic status in patients with type 2 diabetes mellitus. International Journal of Clinical Biochemistry and Research. 7 (1): 130-133. doi.org/10.18231/j.ijcbr.2020.026
28. Reshma S, Sushith S, Prathima MB, Janice D, Madan GR, Gowda P, Kumar KP, Rai M, Kalal BS (2020) Serum electrolytes levels in patients with type 2 diabetes mellitus: a cross-sectional study. Diabetes Mellitus. 23 (3): 223-228. doi.org/10.14341/DM10302
29. Haglin L, Backman L, Tornkvist B (2011) A structural equation model for assessment of links between changes in serum triglycerides, urate, and glucose and changes in serum calcium, magnesium and phosphate in type 2 diabetes and non-diabetes metabolism. Cardiovascular Diabetology. 10: 116. doi: 10.1186/1475-2840-10-116
30. Ugwuja EI, Eze NA (2006) A comparative study of serum electrolytes, total protein, calcium and phosphate among diabetic and HIV/AIDS patients in Abakaliki, Southeastern, Nigeria. The Internet Journal of Laboratory Medicine. 2 (1): 1-8. doi: 10.5580/15e5
31. Al-Jameil N (2014) Estimation of serum electrolytes in diabetes patients of Saudi Region. Life Science Journal. 11 (7): 378-380. doi:10.7537/marslsj110714.44
32. Praveenna S, Pasula S, Sameera K (2013) Trace elements in diabetes mellitus. Journal of Clinical and Diagnostic Research. 7 (9): 1863-1865. doi: 10.7860/JCDR/2013/5464.3335
33. Paolisso G, Sgambato S, Gambardella A, Pizza G, Tesauro P, Varricchio M, D’Onofrio F (1992) Daily magnesium supplements improve glucose handling in elderly subjects. The American Journal of Clinical Nutrition. 55 (6): 1161-1167. doi: 10.1093/ajcn/55.6.1161
34. Pham PC, Pham PM, Pham SV, Miller JM, Pham PT (2007) Hypomagnesemia in patients with type 2 diabetes. Clinical Journal of American Society of Nephrology. 2: 366-373. doi: 10.2215/CJN.02960906
35. Liamis G, Liberopoulos E, Alexandridis G, Elisaf M (2012) Hypomagnesemia in a department of internal medicine. Magnes Research. 25: 149-158. doi: 10.1684/mrh.2012.0325
36. Taylor WH, Khaleeli AA (2005) Coincident diabetes mellitus and primary hyperparathyroidism. Diabetes/ Metabolism Research and Reviews. 17 (3): 175-180. doi: 10.1002/dmrr.199
37. Palmer BF (2011) Metabolic complications associated with use of diuretics. Seminars in Nephrology. 31 (6): 542-552. doi: 10.1016/j.semnephrol.2011.09.009
38. Haglin L, Backman L, Tornkvist B (2011) A structural equation model for assessment of links between changes in serum triglycerides, -urate, and -glucose and changes in serum calcium, -magnesium and-phosphate in type 2 diabetes and non-diabetes metabolism. Cardiovascular Diabetology. 10: 116. doi.10.1186/1475-2840-10-116
39. Yamaguchi T, Kanazawa I, Takaoka S, Sugimoto T (2011) Serum calcium is positively correlated with fasting plasma glucose and insulin resistance, independent of parathyroid hormone, in male patients with type 2 diabetes mellitus. Metabolism. 60 (9): 1334-1339. doi: 10.1016/j.metabol. 2011.02.003
40. Sun G, Vasdev S, Martin GR, Gadag V, Zhang H (2005) Altered calcium homeostasis is correlated with abnormalities of fasting serum glucose, insulin resistance, and beta-cell function in the new found and population. Diabetes. 54 (11): 3336-3339. doi: 10.2337/diabetes.54.11.3336
41. Elhadi AA, Ahmed AA (2022) Correlation of vitamin D with glycemic control and body mass index in patients with type II diabetes mellitus. Mediterranean Journal of Pharmacy and Pharmaceutical Sciences. 2 (1): 29-37. doi.10.5281/zenodo.6399450
42. Agus ZS (1999) Hypomagnesemia. Journal of the American Society of Nephrology. 10 (7): 1616-1622. doi: 10.1681/ASN.V1071616
43. Zhang J, Berra-Romani R, Sinnegger-Brauns MJ, Striessing J, Blaustein MP, Matteson DR (2007) Role of cav1.2 L-type Ca2+ channels in vascular tone: effects of nifedipine and Mg2+. The American Journal of Physiology. Heart and Circulatory Physiology. 292: 415-425. doi: 10.1152/ajpheart .01214.2005
44. Hu Y, Zhou C, Shi Y, She X, Zhao S, Gu C, Xu X, Chen H, Ma M, Zheng Z (2021) A higher serum calcium level is an independent risk factor for vision-threatening diabetic retinopathy in patients with type 2 diabetes: cross-sectional and longitudinal analyses. Endocrinology Practice. 27 (8): 826-833. doi: 10.1016/j.eprac. 2021.05.003
45. Dasgupta A, Sarma D, Saikia UK (2012) Hypomagnesemia in type 2 diabetes mellitus. Indian Journal of Endocrinology and Metabolism. 16 (6): 1000-1003. doi: 10.4103/2230-8210.103020
46. Oh JH, Kim S, Tak Park J, Kim S-J, Han SH, Yoo T-H, Ryu D-R, Kang S-W, Chung YE (2017) Baseline chloride levels are associated with the incidence of contrast-associated acute kidney injury. Scientific Report. 7: 17431. doi: 10.1038ls41598-017-17763-7
47. Kimura T, Hashimito Y, Tanaka M, Asano M, Yamazaki M, Oda Y, Marunaka Y, Nakamura N, Fukui M (2016) Sodium-chloride difference and metabolic syndrome. Internal Medicine. 55 (21): 3085-3090. doi: 10.2169/ internalmedicine.55.7000

Citation :

Ahmed et al. (2023) Serum electrolyte levels in Libyan patients with type II diabetes mellitus. Mediterr J Pharm Pharm Sci. 3 (3): 43-50. https://doi.org/10.5281/zenodo.8372954