Features of the occurrence and course of electrolyte disorders in the acute phase of stroke in patients with diabetes mellitus

O.A. Halushko

Abstract


Background. Electrolyte disturbances that occur in patients with acute stroke (AS) are one of the causes of complications of AS. Concomitant diabetes mellitus (DM) affects the severity of stroke and increases mortality rates. Objective: to investigate the incidence, characteristics and treatment of electrolyte disorders in patients with AS against the background of concomitant DM. Materials and methods. A retrospective analysis of treating 416 patients with AS was conducted. All patients were divided into three groups: 1) patients with DM established before the stroke, 2) patients with newly diagnosed, and 3) patients without DM. The second phase was a pilot study with an analysis of the incidence of magnesium and phosphate metabolic disorders in the patients with AS (20 patients with AS on the background of DM and 10 stroke patients without diabetes). Results. The diabetic history was present in 110 of 416 patients (26.4 %), in another 48 patients (11.5 %) DM was newly diagnosed. Thus, the incidence of diabetes in patients with AS in our study was approximately 38.0 %, much higher than in the corresponding age population. In general, the different types of electrolyte disorders were observed in 258 of 349 (73.9 %) patients with AS, while in patients with underlying disorders of carbohydrate metabolism, these violations occurred significantly more often than in patients without them. In particular, carbohydrate metabolism occurred in 82 (81.2 %) and 36 (83.7 %) patients from groups 1 and 2 versus 134 (65.4 %) in the control group (p < 0.05). Hypomagnesemia (less than 0.8 mmol/L) was observed in 2 of 10 patients (20 %) in AS without carbohydrate disturbances and in 6 of 20 patients (30 %) in AS with concomitant diabetes. Hypophosphatemia (phosphate levels less than 0.8 mmol/L) was not found in AS patients without DM and in 2 patients with AS and concomitant or newly diagnosed diabetes. Following the correction using oral medications containing phosphates and magnesium, blood electrolyte levels was stabilized and that coincided with the improvement of the patients’ condition and the degree of disability. Conclusions. Electrolyte disorders are fairly common problem in patients with concomitant diabetes and AS. In patients with impaired carbohydrate metabolism, we have observed significantly higher incidence (more than 81.2 % of patients) of electrolyte disorders than in patients without it. In case of AS on the background of diabetes, electrolyte disturbances occur significantly more often than in patients without such comorbidities. Further research is needed to elucidate the role of electrolyte disorders (eg, magnesium and phosphate) in the course and consequences of AS.

Keywords


stroke; electrolytes; sodium; potassium; chloride; magnesium; phosphate

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DOI: https://doi.org/10.22141/2224-0586.1.80.2017.94457

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