Sodium Correction for Hyperglycemia Calculator

The Sodium Correction for Hyperglycemia Calculator is a tool used to adjust sodium levels in patients with high blood sugar (hyperglycemia). When blood sugar levels rise, they can affect sodium concentration in the blood. This calculator helps healthcare providers determine the corrected sodium level, ensuring accurate diagnosis and treatment. It is essential for managing conditions like diabetes and preventing complications associated with electrolyte imbalances.

Patient Data Entry Guide

Step 1: Input Laboratory Values

1. Measured Sodium: Enter value + unit (mmol/L or mEq/L).
   • Example: 130 mmol/L
2. Blood Glucose: Enter value + unit (mg/dL or mmol/L).
   • Example: 450 mg/dL

Step 2: Input Demographic Data

3. Age: Enter age in years.
   • Example: 60
4. Sex: Specify Male/Female/Other.
   • Example: Female

Step 3: Select Equation

5. Equation: Choose a correction formula:
   • Katz (1973): Widely used for moderate hyperglycemia.
   • Hillier (1999): Preferred for severe hyperglycemia (glucose >600 mg/dL).

Step 4: Input Symptoms

6. Symptoms: Describe symptoms of hyperglycemia or electrolyte imbalance.
   • Example: Polyuria, confusion, dehydration

Sample Diagnostic Report

Corrected Sodium Calculation

• Measured Sodium: 125 mmol/L
• Blood Glucose: 500 mg/dL
• Selected Equation: Katz Formula

Interpretation

• Normal Sodium Range: 135–145 mmol/L.
• Result: 131.4 mmol/L (Mild hyponatremia after correction).

Symptom Correlation

• Confusion may reflect hyperosmolar state or true electrolyte imbalance.

Recommendations

1. Fluid Management:
   • Administer 0.9% saline if hypovolemic.
   • Correct glucose gradually (target reduction: 50–70 mg/dL/hour).
2. Monitor Electrolytes: Repeat sodium after glucose normalization.
3. Evaluate Causes: Assess for SIADH, diuretic use, or adrenal insufficiency.

Key Considerations

1. Unit Conversions:
   • Glucose (mmol/L → mg/dL): Multiply by 18 (e.g., 25 mmol/L = 450 mg/dL).
   • Sodium: 1 mmol/L = 1 mEq/L.
2. Formula Selection:
   • Katz Formula: Adjusts sodium by 1.6 mmol/L per 100 mg/dL glucose >100.
   • Hillier Formula: Adjusts by 2.4 mmol/L per 100 mg/dL glucose >100 (more aggressive).
3. Limitations:
   • Formulas assume no severe hypertriglyceridemia or paraproteinemia.
   • Accuracy decreases with extreme hyperglycemia (>600 mg/dL).

Equations

1. Katz Formula: Corrected Na⁺ (mmol/L)=Measured Na⁺+0.016×(Glucose (mg/dL)−100)
2. Hillier Formula: Corrected Na⁺ (mmol/L)=Measured Na⁺+0.024×(Glucose (mg/dL)−100)

Hyponatremia Classification

Final Diagnosis: Combines corrected sodium, symptoms, and glucose levels to distinguish pseudohyponatremia from true hyponatremia (e.g., SIADH vs. hyperglycemic dilutional effect).

✅ Formula Verification:

• Katz Example: Na⁺=125, Glucose=500 → 125 + 0.016*(500-100) = 131.4 mmol/L
• Hillier Example: Na⁺=125, Glucose=500 → 125 + 0.024*(500-100) = 134.6 mmol/L

Next Steps

• Calculate serum osmolality:

• Assess volume status (e.g., urine osmolality, urine sodium).
• Rule out adrenal crisis or hypothyroidism.