Relationship between Serum Anion Gap and Diabetes Mellitus

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 < 0.05 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.