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29-10-2024 | Research Letter

A modified total body water deficit formula for use in diabetes care

Author: Philip J. G. M. Voets

Published in: Diabetologia

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Excerpt

To the Editor: Total body water (TBW) balance and glycaemic regulation in the human body are closely intertwined [1, 2]. During glycaemic dysregulation, a large TBW deficit ensues, primarily as a result of osmotic diuresis [1, 2]. The most serious, potentially life-threatening complications of diabetes mellitus, that is, diabetic ketoacidosis (DKA) and hyperosmotic hyperglycaemic syndrome (HHS), produce, on average, TBW deficits of 6–7 l and 9–10 l, respectively [1, 2]. Rational fluid resuscitation is therefore one of the cornerstones of the management of HHS and, to a slightly lesser extent, DKA [13]. Because there is no ‘gold standard’ approach for determining an individual’s TBW status, clinicians use predictive formulas to estimate the TBW deficit [3]. The best-known example of these TBW deficit formulas is shown in Equation (1), which is derived from the change in plasma sodium concentration (\({\left[N{a}^{+}\right]}_{p}\)) from a target concentration (i.e. 140 mmol/l) due to a change in TBW with respect to the original TBW, as estimated by measured body weight (\(W\)) [3]:
$$TBW\;deficit=0.6W\left(\frac{{\left[Na^+\right]}_p}{140}-1\right)$$
(1)
Literature
Metadata
Title
A modified total body water deficit formula for use in diabetes care
Author
Philip J. G. M. Voets
Publication date
29-10-2024
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-024-06311-4

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