TITLE:
Relationship between Serum Anion Gap and Diabetes Mellitus
AUTHORS:
Agoro Eni-Yimini Solomon, Mieebi M. Wankasi, Ogregade Ileimokumo
KEYWORDS:
Anion Gap, Diabetes Mellitus, Serum Anion, Serum Cation, Serum Buffers
JOURNAL NAME:
Journal of Diabetes Mellitus,
Vol.5 No.4,
September
21,
2015
ABSTRACT: Diabetes mellitus is the most common metabolic disorder occasioned by derangement in glucose equilibration
between the ECF and ICF. The derangement is known to affect the appropriate
balance of electrolytes that serves as a
buffer in the body. In this study anion gap was evaluated among outpatient diabetics as compared to non-diabetics control group. The categorization into the study or control groups
was done by serum glucose estimation using glucose oxidase method. The study
group mean age was 51 ±14 as against control group of 47 ± 10. One hundred and fifty subjects were divided in two groups based on serum glucose concentration. Group A (control group) consisted of 50 subjects with mean serum glucose concentration 4.3 ±1.7 mmol/l and anion gap 13.8 ± 2.6, group B (diabetics) consisted of 100 subjects that had serum glucose concentration 15.0 ± 3.9 and anion gap 18.4 ± 2.5. The glucose was estimation by glucose oxidase
method, whereas the anion gap was calculated by subtracting the concentrations
of sodium and potassium from the concentrations of chloride and bicarbonate.
The concentrations of the electrolytes where assayed using ion selective
electrodes (ISE). A statistical significant difference P was
observed between group A and B glucose concentrations and the anion gap. The
abnormal anion gap was created by the insufficiency of bicarbonate used for the
buffering of the electrolytes variability occasioned by derangement in glucose
metabolism and distorted hormonal secretion. Hence metabolic acidosis is
strongly linked with diabetics as a result of distorted anion gap. Healthcare providers
and takers should ensure that anion gap estimation is factored into
investigations for the management of
diabetics. Also, patients with deranged anion gap should be placed as an emergency
case for proper management. Clinicians should ensure that patient’s anion gap
is within the reference anion gap range so as to prevent development into
metabolic acidosis and subsequent ketoacidosis.