Serum Sodium

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.

Antidiuretic Hormone

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

Lab criteria

Deficits per body weight

Total deficit

Compartment

Water

Sodium

Chloride

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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