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Disturbance of inorganic phosphate metabolism in diabetes mellitus: clinical manifestations of phosphorus-depletion syndrome during recovery from diabetic ketoacidosis

Authors Ditzel J, Lervang H

Published 20 September 2010 Volume 2010:3 Pages 319—324

DOI https://doi.org/10.2147/DMSO.S13476

Review by Single-blind

Peer reviewer comments 3


Jørn Ditzel, Hans-Henrik Lervang
Department of Endocrinology, and Center for Prevention of Struma and Metabolic Diseases, Aalborg University Hospital, Aarhus University, Denmark

Abstract: The acute effects of intracellular phosphate depletion and hypophosphatemia on organs and tissues in and during recovery from diabetic ketoacidosis (DKA) have been reviewed. When insufficient phosphate and/or oxygen are available for high energy phosphate synthesis, cell homeostasis cannot be maintained and cell integrity may be impaired. The clinical consequences are recognized as occasional cause of morbidity and mortality. Although phosphate repletion has not been routinely recommended in the treatment of DKA, physicians should be aware of these clinical conditions and phosphate repletion in such situations should be considered.

Keywords: high energy phosphates, hypoxia, fructose 1,6-diphosphate

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