The loss of sodium in diabetic ketoacidosis is severe. The plasma levels of sodium can be variable, but are low in most cases. Very low sodium levels can be associated with vomiting. Several factors affect the regulation of sodium concentration in diabetic ketoacidosis.
The two most important stimuli of antidiuretic hormone (ADH) secretion are hypovolemia via non-osmotic volume and baroreceptor-mediated stimuli, and hyperosmolality, via osmotic stimuli. Both factors are present in diabetic ketoacidosis, leading to a strong stimulation of ADH secretion. Especially the intracerebral hypertonicity caused by hyperglycemia leads to
TABLE 6 Electrolyte and Water Losses from Intracellular and Extracellular Space in Diabetic Coma
Deficits per body weight
100-150 mL/kg 5-13 mmol/kg 5-7 mmol/kg 4-10 mmol/kg 0.5-4 mmol/kg
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