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Abstract
Background: Electrolyte imbalances frequently complicate type 2 diabetes and increase the risk of morbidity. Evidence on how glycemic control shapes these disturbances remains limited in Pakistan.
Methods: We carried out a cross-sectional study of 136 adults with type 2 diabetes attending a tertiary care hospital in Bahawalpur. We recorded demographic and clinical characteristics, measured serum electrolytes, and assessed glycemic status using HbA1c. We compared the prevalence of sodium and potassium disturbances between patients with and without glycemic control and examined associations with comorbidities and duration of disease.
Results: Most participants were aged 61–80 years (69.1%), and nearly seven in ten had poor glycemic control. Hyponatremia (39.7%) and hypokalemia (34.6%) were the most frequent abnormalities, followed by hyperkalemia (25.7%) and hypernatremia (15.4%). Hyponatremia occurred more often in patients with longer duration of diabetes, poor glycemic control, and hypertension (p<0.05). Hypernatremia was less common and showed a significant association only with lower educational status (p=0.01). Hypokalemia was more frequent in younger patients and those with hypertension, while hyperkalemia was strongly associated with poor glycemic control, hypertension, and obesity (p<0.05).
Conclusion: Electrolyte disturbances were highly prevalent among patients with type 2 diabetes, with sodium and potassium abnormalities most prominent. Poor glycemic control and cardiometabolic comorbidities shaped these patterns. Regular monitoring of serum electrolytes alongside HbA1c may help clinicians prevent complications and improve outcomes in this high-risk population.