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Electrolyte Imbalance in Diabetes

By Larry Armstrong ; Updated August 14, 2017

Electrolytes are crucial to the function of every cell in the body. This is why electrolytes are tightly regulated, and why the body expends considerable energy to maintain a constant balance between the various electrolytes. Under conditions where a disease such as diabetes upsets metabolic function, the body’s electrolyte control system breaks down. Since the results of electrolyte imbalance can be severe, managing electrolytes is a major issue in diabetic care.


Electrolytes such as sodium, potassium, calcium, magnesium and chloride come from minerals in your diet. Once the minerals are in a water environment, they are able to carry an electrical charge. The amount of one electrolyte relative to another is important to how every cell in the body functions at its most fundamental level. Physiological functions such as water balance, nerve signal transmission and energy utilization are just some examples that depend on a fine balance between the body’s electrolytes.

Electrolyte Control

As food is digested, the body extracts and then circulates electrolytes in the blood stream to be utilized by all tissues. Each cell dictates to the tissues its need for certain electrolytes. As the tissues use the electrolytes from the blood, the kidneys detect their total levels as well as the ratio of one electrolyte to another. The kidneys then adjust the rate of electrolyte retention or excretion in the urine to keep serum electrolyte levels constant. During certain conditions such as dehydration, diarrhea, renal failure and diabetes, the kidneys can fail to operate properly. This can result in problems with removal or retention of electrolytes. When this happens, the relative ratios of electrolytes can change, producing a cascading chain of events resulting in a variety of symptoms.


When people use the word diabetes, they usually refer to diabetes mellitus instead of rarer forms of the disease. Diabetes is characterized by high blood glucose levels or hyperglycemia. It is a result of insulin deficiency or the body’s inability to use insulin. The consequences of diabetes are numerous, ranging from metabolic imbalance to nerve and blood vessel degeneration. One primary problem with diabetes is that the amount of glucose in the blood can offset the proportion of electrolytes. The association between blood glucose and electrolytes is a complex one and is related to a number of other factors such as age and associated conditions.

Electrolyte Imbalance

Electrolyte imbalance in diabetes is primarily a result of elevated blood glucose. With hyperglycemia, the body tries to rid itself of the excess blood glucose by increasing urinary output. Increased urination produces water and electrolyte loss, which then upsets the body’s balance of electrolytes. The balance is especially disturbed between sodium and potassium. Symptoms of electrolyte imbalance include headache, fatigue, muscle pain and irritability, according to the Mayo Clinic. As cells become more starved of glucose for their energy needs, the body tries to compensate by providing another energy source. That source comes from fatty acids, which are less efficient energy producing chemicals. Fatty acid metabolism can lead to a buildup of a byproduct called ketones, which can upset the acid and base relationship of the body. That acid/base upset may result in a condition known as ketoacidosis, which can be severe and even life threatening.

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