Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia

Ahsan Keepurath Asharaf; Rincy Kadavath; Prajitha Ajithkumaran Pillai Prasannakumari

doi:doi:10.11648/j.ijde.20261101.12

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Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia

Ahsan Keepurath Asharaf^*

, Rincy Kadavath, Prajitha Ajithkumaran Pillai Prasannakumari

Published in International Journal of Diabetes and Endocrinology (Volume 11, Issue 1)

Received: 28 February 2026 Accepted: 16 March 2026 Published: 2 April 2026

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Abstract

Hyponatremia is one of the most frequently encountered electrolyte abnormalities in clinical practice and is associated with significant morbidity and mortality. Among its various forms, hyperglycaemia-induced hyponatremia represents a unique and often reversible subtype characterized by a reduction in measured serum sodium concentration in the presence of elevated plasma glucose levels. This phenomenon is primarily driven by osmotic shifts of water from the intracellular to the extracellular compartment, resulting in dilutional hyponatremia rather than a true deficit of total body sodium. Hyperglycaemia itself is a frequently observed biochemical abnormality and may be detected incidentally during routine laboratory testing in asymptomatic individuals. It can also occur in situations that place increased demand on pancreatic β-cells, such as pregnancy, severe illness, or treatment with medications like corticosteroids, a condition commonly referred to as stress hyperglycaemia. In some cases, however, patients present with acute metabolic emergencies caused by uncontrolled hyperglycaemia, including diabetic ketoacidosis, which requires prompt medical intervention. Understanding the relationship between hyperglycaemia and hyponatremia is clinically important, as the reduction in serum sodium in these cases primarily reflects osmotic fluid shifts rather than actual sodium depletion. Consequently, management should focus on correcting the underlying hyperglycaemia, which typically leads to normalization of serum sodium levels. Recognizing this mechanism helps clinicians avoid unnecessary sodium replacement and guides appropriate treatment strategies for patients with diabetes presenting with electrolyte abnormalities.

Published in	International Journal of Diabetes and Endocrinology (Volume 11, Issue 1)
DOI	10.11648/j.ijde.20261101.12
Page(s)	7-12
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Hyperglycemia, Hyponatremia, Syzygium Jambolanum

1. Introduction

Hyponatremia associated with hyperglycemia in diabetic patients represents a dilutional decrease in serum sodium caused by osmotic water shifts from the intracellular to the extracellular space due to elevated blood glucose levels. This condition, known as trans locational hyponatremia, does not reflect a true loss of sodium but rather an alteration in fluid distribution. As blood glucose levels are corrected, the osmotic gradient normalizes and serum sodium concentrations typically return toward normal. Hyponatremia, defined as a plasma sodium concentration below 135 mM, is one of the most common electrolyte disorders encountered in clinical practice, occurring in up to 22% of hospitalized patients

[1]

. The mechanisms underlying hyponatremia often involve an exaggerated or inappropriate secretion of arginine vasopressin (AVP), which plays a key role in regulating water balance. The specific pathophysiology varies depending on the patient’s extracellular fluid volume (ECFV) status, with different mechanisms operating in hypovolemic, euvolemic, and hypervolemic states

[2]

. Hyponatremia leads to widespread cellular swelling as water shifts along the osmotic gradient from the hypotonic extracellular fluid (ECF) into the intracellular fluid (ICF). The condition is sometimes termed “water intoxication,” particularly when it results from excessive water consumption without sufficient sodium replacement, which may occur during prolonged or strenuous exercise

[5]

. The clinical manifestations of hyponatremia are predominantly neurological because of the development of cerebral edema within the confined space of the skull. During the early phase of acute hyponatremia, the central nervous system responds by increasing interstitial pressure, which promotes the movement of extracellular fluid and solutes from the interstitial compartment into the cerebrospinal fluid and subsequently into the systemic circulation. This adaptive response is accompanied by the loss of major intracellular ions, including sodium (Na⁺), potassium (K⁺), and chloride (Cl⁻), from brain cells. Acute hyponatremic encephalopathy develops when these regulatory mechanisms are unable to compensate for a rapid decline in extracellular tonicity, leading to the accumulation of fluid in brain tissue and the development of cerebral edema. Early clinical features may include nausea, headache, and vomiting. If the condition progresses, serious complications such as seizures, brainstem herniation, coma, and death may occur. An important complication of acute hyponatremia is respiratory failure that may present as normocapnic or hypercapnic. The resulting hypoxia can further worsen neurological damage. In many cases, normocapnic respiratory failure is associated with non-cardiogenic or “neurogenic” pulmonary edema, which occurs despite a normal pulmonary capillary wedge pressure. Because of these potentially life-threatening consequences, acute symptomatic hyponatremia is considered a medical emergency and can arise in several specific clinical situations.

The typical manifestations of type 1 diabetes include excessive thirst, frequent urination, nocturia, and rapid loss of body weight. In contrast, these classical symptoms are often not evident in individuals with type 2 diabetes, many of whom remain asymptomatic or report only vague complaints such as persistent fatigue and general malaise. Poorly controlled diabetes is also associated with a higher risk of infections. Patients may therefore present with cutaneous infections such as boils, as well as genital candidiasis, and may report symptoms including pruritus vulvae or balanitis. Furthermore, when plasma sodium levels decline rapidly to values below approximately 115–120 mmol/L, cerebral edema may develop, potentially resulting in seizures, coma, irreversible neurological injury, or death

[4]

The diagnosis of diabetes is influenced by the patient’s mode of clinical presentation. More than 70% of individuals with type 2 diabetes are overweight, and the pattern of obesity is often central, involving the abdominal or truncal region. However, obesity appears to be less prevalent among patients in developing countries. Approximately half of the individuals with type 2 diabetes also have hypertension. Hyperlipidemia is frequently observed in these patients, although visible lipid-related skin manifestations such as xanthelasma and eruptive xanthomas occur relatively infrequently. The tissue changes associated with diabetes are generally similar across different types of the disease, suggesting that chronic hyperglycemia, or a closely related metabolic disturbance, plays a major role in their development

[3]

As a rule, chronic hyponatremia without symptoms can be corrected slowly over 2-3 days, often by water restriction alone, whereas severe hyponatremia (generally < 120 mmol/L) of rapid onset with symptoms requires urgent correction. A target value of 130 mmol/L is appropriate. This should be done in a high-dependency setting with frequent careful monitoring. Hypertonic saline may be used with caution in severe acute cases. The rate of rise in the plasma sodium should not exceed 0.5 mmol//hr (12 mmol/day) in order to minimize the risk of myelinolysis.

There is a clinically important relationship between the decrease in plasma Na⁺ concentration and the increase in plasma glucose concentration seen in diabetes and other hyperglycemic syndromes

[6]

Patients with higher blood glucose concentrations showed hyponatremia. Hyperglycemia increases extracellular osmolality, causing water to shift from the intracellular to the extracellular space, which dilutes serum sodium concentration. Therefore, as blood glucose rises, measured serum sodium falls. The decline in serum sodium represents a well-known osmoregulatory response to hyperglycemia

[7]

. Hypertonicity secondary to hyperglycemia is thought to be the major cause of hyponatremia in diabetic ketoacidosis

[8]

This journal aims to study the case of hyponatremia with hyperglycemia presented in a 48- year-old male and it was managed successfully by Homeopathically with proper medication and its follow up.

2. Case Summary

This is the case of a 48-year-old male with hyponatremia along with hyperglycemia. The case presented here is from OPD -6 of Government Homoeopathic medical college and Hospital, Trivandrum, Kerala. The patient was treated with specific homoeopathic Medicine over a period of 9 days. There was significant improvement with homoeopathic treatment.

3. Case Report

A 48-year-old male reported with hyponatremia with hyperglycemia at the community medicine OPD in Government Homoeopathic Medical College Trivandrum, Kerala, India on 27 Oct 2025. He presented with general weakness with throbbing pain in right frontal region for 5 days. He also had impaired memory. He is known to be diabetic.

3.1. History of Presenting Complaint

The patient had a history of occasional headache on frontal Complaint started 4 days back as throbbing pain in right frontal region along with general weakness. He is known to be diabetic. Under homoeopathic treatment for 5 years.

3.2. Personal History

He prefers a pure vegetarian diet since 2000 as part of religious belief and has no tobacco, alcohol, or other stimulant addictions.

3.3. Mind and Disposition

1) Gets angered easily.

2) Religious.

3.4. Physical Generals

Thermal reaction: hot patient; desire for sweets.

3.5. Clinical Findings

Pulse rate: 88 beats/ min

Respiratory rate: 18 breaths/ min

Blood pressure: 124/80 mmHg

SpO₂: 97%

GRBS: 360mg/dl

4. Intervention

First prescription: On 27 Oct 2025, Syzygium jambolanum 30 (3-3-3) along with IVF (0.9% Normal saline 100ml/hour).

Basis of prescription: Medicine selected based on specificity, symptom totality

[11]

and in consultation with Materia Medica was Syzygium jambolanum

[9]

. This was chosen as it is specific for patient’s condition. Syzygium jambolanum helps to control diabetes by acting on the pancreas and improving the body’s ability to regulate blood sugar. It reduces excessive formation of sugar in the blood and decrease the excretion of sugar in the urine

[10]

. This remedy helps to balance metabolism and improve symptoms such as intense thirst, frequent urination, and weakness. On subsequent follow-ups, medicine was repeated without changing the potency based on the assessment of patient’s condition.

5. Follow up & Outcomes

Table 1. Follow-up, observations and treatment outcomes.

Date	Follow up	Prescription
28/10/2025	General weakness persists. Pain in right frontal region persist. HBA1C: 9% FBS- 378mg/dl Serum Na+ 130meq/litre. Serum K+ 4 meq/litre.	Rx Syzygium jambolanum 30 (3-3-3) IVF (0.9% saline 100ml/hr.)
29/10/2025	General weakness improved. Pain in right frontal region ameliorated. Serum Na+ 131meq/litre. Serum K+ 4.72meq/litre. FBS--368 mg/dl.	Rx 1. Syzygium jambolanum30 (3-3-3)
30/10/2025	General weakness improved. Pain in right frontal region ameliorated. Serum Na+ 134meq/litre. Serum K+ 4.9meq/litre. FBS-368 mg/dl.	Rx 1. Syzygium jambolanum30 (3-3-3)
31/10/2025	General weakness improved. Pain in right frontal region ameliorated. Serum Na+ 135meq/litre. Serum K+ 5.2meq/litre. FBS-362mg/ dl.	Rx 1. Syzygium jambolanum30 (3-3-3) 2. IVF (0.9% saline 90ml/ hour). 3. Advised for diabetic diet.
01/11/2025	General weakness improved. Pain in right frontal region ameliorated. FBS-358mg/dl.	Rx 1. Syzygium jambolanum30 (3-3-3)
02/11/2025	General weakness improved. Pain in right frontal region ameliorated. FBS-320mg/dl. Serum Na+ 137meq/litre. Serum K+ 5.6meq/litre	Rx 1. Syzygium jambolanum30 (3-3-3)
03/11/2025	General weakness improved. Pain in right frontal region ameliorated. FBS-322mg/dl.	Rx 1. Syzygium jambolanum30 (3-3-3)
04/11/2025	General weakness improved. Pain in right frontal region ameliorated. FBS -291mg/dl.	Rx 1. Syzygium jambolanum30 (3-3-3)
05/11/2025	General weakness improved. Pain in right frontal region ameliorated. FBS – 296mg/dl.	Rx 1. Syzygium jambolanum30 (3-3-3)
06/11/2025	General weakness improved. Pain in right frontal region ameliorated. FBS- 250 mg/l Serum Na+ 138meq/litre. Serum K+ 5.8meq/litre	Rx 1. Syzygium jambolanum30 (3-3-3)

5.1. MONARCH Inventory Score

The MONARCH inventory 20, 21 applied in this case study showed a total score of (10/(13 (Table 2). Details of the positive scores are as follows: criteria 1, 2, 4, and 5 (improvement in general well-being of the patient as assessed by interview with the patient on multiple visits); Based on the MONARCH score, it can be concluded that there is some evidence to attribute a causal link between the treatment and the clinical improvement in the patient.

5.2. Patient Perspective

The patient reports that he is feeling healthier, more active, and has a sense of mental peace. He says, “I feel very happy that after taking homeopathic treatment for his condition, his headache and general weakness improved and he feels healthier and energetic while doing my daily work”. After being relieved by homeopathy for management of his condition, he was relieved of his physical complaints. He ended his remarks by stating that all of his complaints had gradually faded away, and he was satisfied that his mind was also at peace.

6. Results

General weakness of the patient relieved after the medication Syzygium jambolanum 30 and showed significant improvement in serum sodium levels and reduction in fasting blood sugar levels by 9 days of hospital stay.

Table 2. MONARCH Inventory Score.

NO:	Domain	Yes
1.	Was there an improvement in the main symptom or condition for which the homoeopathy medicine was prescribed?	+2
2.	Did the clinical improvement occur within a plausible time frame relative to the medicine intake?	+1
3.	Was there a homeopathic aggravation of symptoms?	0
4.	Did the effect encompass more than the main symptom or condition (i.e., were other symptoms, not related to the main presenting complaint, improved or changed)?	+1
5.	Did overall well-being improve? (Suggest using a validated scale or mention about changes in physical, emotional, and behavioral elements)	+2
6 A	Direction of cure: did some symptoms improve in the opposite order of the development of the symptoms of the disease?	+1
6 B	Direction of cure: did at least two of the following aspects apply to the order of improvement of symptoms: from organs of more importance to those of less importance? from deeper to more superficial aspects of the individual? from the top downwards?	+1
7.	Did “old symptoms” (defined as non-essential and non-clinical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement?	+1
8.	Are there alternative causes (i.e., other than the medicine) that—with a high probability—could have produced the improvement? (Consider known course of disease, other forms of treatment, and other clinically relevant interventions)	0
9.	Was the health improvement confirmed by any objective evidence? (e.g., investigations, clinical examination, etc.)	+1
10.	Did repeat dosing, if conducted, create similar clinical improvement?	+1
	Total score	11

MONARCH Inventory (improved version of the Modified Naranjo Criteria for Homeopathy). Maximum possible score +13, minimum score -6.

7. Conclusion

Homoeopathy is a specialized system of medicine. It treats patient as a whole and not just symptoms. A complete cure of hyponatremia with hyperglycemia treated without any recurrence or complications. This case shows a positive role of Homoeopathy in treating hyponatremia. However, as this is a single case study and it may recur, well designed studies may be taken for scientific validation of results.

Abbreviations

AVP	Arginine Vasopressin
ECFV	Extracellular Fluid Volume

Author Contributions

Ahsan Keepurath Asharaf: Conceptualization, Investigation, Methodology, Resources, Supervision, Validation, Writing – review & editing

Rincy Kadavath: Data curation, Formal Analysis, Project administration, Resources

Prajitha Ajithkumaran Pillai Prasannakumari: Writing – original draft

Conflicts of Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

[1]	Piero Portincasa and David Q-H. Wang (2018). Fluid and Electrolyte Disturbances: Harrison’s principles of internal medicine, 21st edition.
[2]	Penman ID, Ralston SH, Strachan MWJ, Hobson R, editors. Davidson’s Principles and Practice of Medicine. 24^th ed. Elsevier Health Sciences; 2022.
[3]	W. Chapman and Jane Collier (2015). Endocrine disorders: Oxford textbook of medicine sixth edition, volume -2: Section 13.
[4]	Hall JE. Guyton and Hall textbook of medical physiology. The body fluids and kidneys: 14^th ed. Philadelphia: Elsevier; 2021.
[5]	Gupta Y. Hyponatremia: a case study with homoeopathic treatment. International Journal of Homoeopathic Sciences. S. K. Homoeopathic Medical College & Research Centre, Sitapura, Jaipur, Rajasthan, India.
[6]	Wolf MB. Hyperglycemia-induced hyponatremia: Reevaluation of the Na⁺ correction factor. https://doi.org/10.1016/j.jcrc.2017.06.025
[7]	McNair P, Madsbad S, Christiansen C, et al. Hyponatremia and hyperkalemia in relation to hyperglycemia in insulin-treated diabetic out-patients. https://doi.org/10.1016/0009-8981(82)90161-9
[8]	Twomey PJ, Cordle J, Pledger DR, Miao Y. An unusual case of hyponatraemia in diabetic ketoacidosis.
[9]	Boericke W. Boericke’s New Manual of Homoeopathic Materia Medica with Repertory. Third Revised and Augmented Edition Based on Ninth Edition. New Delhi, India: B. Jain Publishers; 2010.
[10]	Allen HC. Keynotes and characteristics with comparisons of some of the leading remedies of the materia medica. New Delhi: B Jain Publishers; 2002.
[11]	Clarke JH. A dictionary of practical materia medica. Vol. 1–3. New Delhi: B Jain Publishers; 1999.

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Asharaf, A. K., Kadavath, R., Prasannakumari, P. A. P. (2026). Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia. International Journal of Diabetes and Endocrinology, 11(1), 7-12. https://doi.org/10.11648/j.ijde.20261101.12

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ACS Style

Asharaf, A. K.; Kadavath, R.; Prasannakumari, P. A. P. Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia. Int. J. Diabetes Endocrinol. 2026, 11(1), 7-12. doi: 10.11648/j.ijde.20261101.12

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AMA Style

Asharaf AK, Kadavath R, Prasannakumari PAP. Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia. Int J Diabetes Endocrinol. 2026;11(1):7-12. doi: 10.11648/j.ijde.20261101.12

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@article{10.11648/j.ijde.20261101.12,
  author = {Ahsan Keepurath Asharaf and Rincy Kadavath and Prajitha Ajithkumaran Pillai Prasannakumari},
  title = {Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia},
  journal = {International Journal of Diabetes and Endocrinology},
  volume = {11},
  number = {1},
  pages = {7-12},
  doi = {10.11648/j.ijde.20261101.12},
  url = {https://doi.org/10.11648/j.ijde.20261101.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20261101.12},
  abstract = {Hyponatremia is one of the most frequently encountered electrolyte abnormalities in clinical practice and is associated with significant morbidity and mortality. Among its various forms, hyperglycaemia-induced hyponatremia represents a unique and often reversible subtype characterized by a reduction in measured serum sodium concentration in the presence of elevated plasma glucose levels. This phenomenon is primarily driven by osmotic shifts of water from the intracellular to the extracellular compartment, resulting in dilutional hyponatremia rather than a true deficit of total body sodium. Hyperglycaemia itself is a frequently observed biochemical abnormality and may be detected incidentally during routine laboratory testing in asymptomatic individuals. It can also occur in situations that place increased demand on pancreatic β-cells, such as pregnancy, severe illness, or treatment with medications like corticosteroids, a condition commonly referred to as stress hyperglycaemia. In some cases, however, patients present with acute metabolic emergencies caused by uncontrolled hyperglycaemia, including diabetic ketoacidosis, which requires prompt medical intervention. Understanding the relationship between hyperglycaemia and hyponatremia is clinically important, as the reduction in serum sodium in these cases primarily reflects osmotic fluid shifts rather than actual sodium depletion. Consequently, management should focus on correcting the underlying hyperglycaemia, which typically leads to normalization of serum sodium levels. Recognizing this mechanism helps clinicians avoid unnecessary sodium replacement and guides appropriate treatment strategies for patients with diabetes presenting with electrolyte abnormalities.},
 year = {2026}
}

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TY  - JOUR
T1  - Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia
AU  - Ahsan Keepurath Asharaf
AU  - Rincy Kadavath
AU  - Prajitha Ajithkumaran Pillai Prasannakumari
Y1  - 2026/04/02
PY  - 2026
N1  - https://doi.org/10.11648/j.ijde.20261101.12
DO  - 10.11648/j.ijde.20261101.12
T2  - International Journal of Diabetes and Endocrinology
JF  - International Journal of Diabetes and Endocrinology
JO  - International Journal of Diabetes and Endocrinology
SP  - 7
EP  - 12
PB  - Science Publishing Group
SN  - 2640-1371
UR  - https://doi.org/10.11648/j.ijde.20261101.12
AB  - Hyponatremia is one of the most frequently encountered electrolyte abnormalities in clinical practice and is associated with significant morbidity and mortality. Among its various forms, hyperglycaemia-induced hyponatremia represents a unique and often reversible subtype characterized by a reduction in measured serum sodium concentration in the presence of elevated plasma glucose levels. This phenomenon is primarily driven by osmotic shifts of water from the intracellular to the extracellular compartment, resulting in dilutional hyponatremia rather than a true deficit of total body sodium. Hyperglycaemia itself is a frequently observed biochemical abnormality and may be detected incidentally during routine laboratory testing in asymptomatic individuals. It can also occur in situations that place increased demand on pancreatic β-cells, such as pregnancy, severe illness, or treatment with medications like corticosteroids, a condition commonly referred to as stress hyperglycaemia. In some cases, however, patients present with acute metabolic emergencies caused by uncontrolled hyperglycaemia, including diabetic ketoacidosis, which requires prompt medical intervention. Understanding the relationship between hyperglycaemia and hyponatremia is clinically important, as the reduction in serum sodium in these cases primarily reflects osmotic fluid shifts rather than actual sodium depletion. Consequently, management should focus on correcting the underlying hyperglycaemia, which typically leads to normalization of serum sodium levels. Recognizing this mechanism helps clinicians avoid unnecessary sodium replacement and guides appropriate treatment strategies for patients with diabetes presenting with electrolyte abnormalities.
VL  - 11
IS  - 1
ER  -

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Author Information

Ahsan Keepurath Asharaf

Department of Community Medicine, Government Homoeopathic Medical College, Trivandrum, India

Contact Email

http://orcid.org/0000-0001-5123-0541
Rincy Kadavath

Department of Community Medicine, Government Homoeopathic Medical College, Trivandrum, India
Prajitha Ajithkumaran Pillai Prasannakumari

Department of Community Medicine, Government Homoeopathic Medical College, Trivandrum, India

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Asharaf, A. K., Kadavath, R., Prasannakumari, P. A. P. (2026). Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia. International Journal of Diabetes and Endocrinology, 11(1), 7-12. https://doi.org/10.11648/j.ijde.20261101.12

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ACS Style

Asharaf, A. K.; Kadavath, R.; Prasannakumari, P. A. P. Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia. Int. J. Diabetes Endocrinol. 2026, 11(1), 7-12. doi: 10.11648/j.ijde.20261101.12

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AMA Style

Asharaf AK, Kadavath R, Prasannakumari PAP. Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia. Int J Diabetes Endocrinol. 2026;11(1):7-12. doi: 10.11648/j.ijde.20261101.12

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@article{10.11648/j.ijde.20261101.12,
  author = {Ahsan Keepurath Asharaf and Rincy Kadavath and Prajitha Ajithkumaran Pillai Prasannakumari},
  title = {Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia},
  journal = {International Journal of Diabetes and Endocrinology},
  volume = {11},
  number = {1},
  pages = {7-12},
  doi = {10.11648/j.ijde.20261101.12},
  url = {https://doi.org/10.11648/j.ijde.20261101.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20261101.12},
  abstract = {Hyponatremia is one of the most frequently encountered electrolyte abnormalities in clinical practice and is associated with significant morbidity and mortality. Among its various forms, hyperglycaemia-induced hyponatremia represents a unique and often reversible subtype characterized by a reduction in measured serum sodium concentration in the presence of elevated plasma glucose levels. This phenomenon is primarily driven by osmotic shifts of water from the intracellular to the extracellular compartment, resulting in dilutional hyponatremia rather than a true deficit of total body sodium. Hyperglycaemia itself is a frequently observed biochemical abnormality and may be detected incidentally during routine laboratory testing in asymptomatic individuals. It can also occur in situations that place increased demand on pancreatic β-cells, such as pregnancy, severe illness, or treatment with medications like corticosteroids, a condition commonly referred to as stress hyperglycaemia. In some cases, however, patients present with acute metabolic emergencies caused by uncontrolled hyperglycaemia, including diabetic ketoacidosis, which requires prompt medical intervention. Understanding the relationship between hyperglycaemia and hyponatremia is clinically important, as the reduction in serum sodium in these cases primarily reflects osmotic fluid shifts rather than actual sodium depletion. Consequently, management should focus on correcting the underlying hyperglycaemia, which typically leads to normalization of serum sodium levels. Recognizing this mechanism helps clinicians avoid unnecessary sodium replacement and guides appropriate treatment strategies for patients with diabetes presenting with electrolyte abnormalities.},
 year = {2026}
}

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TY  - JOUR
T1  - Electrolyte Imbalance in Diabetes Mellitus: A Case Report on Homoeopathic Management of Hyperglycemia-induced Hyponatremia
AU  - Ahsan Keepurath Asharaf
AU  - Rincy Kadavath
AU  - Prajitha Ajithkumaran Pillai Prasannakumari
Y1  - 2026/04/02
PY  - 2026
N1  - https://doi.org/10.11648/j.ijde.20261101.12
DO  - 10.11648/j.ijde.20261101.12
T2  - International Journal of Diabetes and Endocrinology
JF  - International Journal of Diabetes and Endocrinology
JO  - International Journal of Diabetes and Endocrinology
SP  - 7
EP  - 12
PB  - Science Publishing Group
SN  - 2640-1371
UR  - https://doi.org/10.11648/j.ijde.20261101.12
AB  - Hyponatremia is one of the most frequently encountered electrolyte abnormalities in clinical practice and is associated with significant morbidity and mortality. Among its various forms, hyperglycaemia-induced hyponatremia represents a unique and often reversible subtype characterized by a reduction in measured serum sodium concentration in the presence of elevated plasma glucose levels. This phenomenon is primarily driven by osmotic shifts of water from the intracellular to the extracellular compartment, resulting in dilutional hyponatremia rather than a true deficit of total body sodium. Hyperglycaemia itself is a frequently observed biochemical abnormality and may be detected incidentally during routine laboratory testing in asymptomatic individuals. It can also occur in situations that place increased demand on pancreatic β-cells, such as pregnancy, severe illness, or treatment with medications like corticosteroids, a condition commonly referred to as stress hyperglycaemia. In some cases, however, patients present with acute metabolic emergencies caused by uncontrolled hyperglycaemia, including diabetic ketoacidosis, which requires prompt medical intervention. Understanding the relationship between hyperglycaemia and hyponatremia is clinically important, as the reduction in serum sodium in these cases primarily reflects osmotic fluid shifts rather than actual sodium depletion. Consequently, management should focus on correcting the underlying hyperglycaemia, which typically leads to normalization of serum sodium levels. Recognizing this mechanism helps clinicians avoid unnecessary sodium replacement and guides appropriate treatment strategies for patients with diabetes presenting with electrolyte abnormalities.
VL  - 11
IS  - 1
ER  -

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