ABSTRACT
INTRODUCTION Diabetes mellitus is a chronic complex metabolic disorder that, in addition to the dysregulation of glucose, fat and protein metabolism, may be accompanied by disturbances in water, electrolyte and acid-base balance. Abnormalities in plasma electrolytes and acid-base homeostasis in diabetes mellitus may result from the following
1) hyperglycaemia 2) derangement in the normal tubular action of insulin 3) altered renal haemodynamics and perturbations in extracellular fluid volume, often associated with
secondary abnormalities in glomerulotubular feedback 4) structural changes in the renal tubular cells, including thickening of the glomerular basement
membrane, and accumulation of glycogen in the cytosol and lysosomes1 5) hyporeninaemic hypoaldosteronism 6) altered tubular function due to tubulointerstitial disease 7) drug therapy 8) decompensated diabetes mellitus, with ketosis or hyperosmolar states 9) renal failure.
