Vnitr Lek 2026, 72(3):E1-E4 | DOI: 10.36290/vnl.2026.041
Diabetic ketoacidosis and hypophosphatemia
- 1 Klinika hemato-onkologie a buněčné terapie, Univerzitní nemocnice Magdeburg, Německo
- 2 Interní klinika 2. LF UK a FN Motol a Homolka, Praha
Hypophosphatemia is a common but generally underestimated electrolyte abnormality associated with diabetic ketoacidosis (DKA) that can cause serious clinical complications. Monitoring and, if necessary, supplementation of phosphate levels should be an integral part of the care of patients with diabetic ketoacidosis, although routine supplementation is not currently recommended.
Keywords: diabetic ketoacidosis, hypophosphatemia, insulin, potassium, diabetes.
Accepted: April 24, 2026; Published: May 18, 2026 Show citation
References
- Innere Medizin - eine vorlesungsorientierte Darstellung 2019; Dr. med. Gerd Herold und Mitarbeiter: Wasser - und Elektrolythaushalt, Herausgeber: Gerd Herold, Köln 2019; s. 571-590.
Go to original source... - van der Vaart A, Waanders F, van Beek AP, Incidence and determinants of hypophosphatemia in diabetic ketoacidosis: an observational study. BMJ Open Diabetes Res Care. 2021; 9(1):e002018.
Go to original source...
Go to PubMed... - Rashed R, Hyassat D, Batieha A; Prevalence and Correlates of Hypophosphatemia Among Type 2 diabetic patients attending the National Center for Diabetes, Endocrinology and genetics (NCDEG). Ann Med Surg (Lond). 2022;78:103770
Go to original source...
Go to PubMed... - Amanzadeh, J., Reilly, R. Hypophosphatemia: an evidence-based approach to its clinical consequences and management. Nat Rev Nephrol 2006;2:136-148.
Go to original source...
Go to PubMed... - Taylor SI, Blau JE, Rother KI. Possible adverse effects of SGLT2 inhibitors on bone. Lancet Diabetes Endocrinol. 2015;3(1):8-10.
Go to original source... - Ciafardini A, Vena W, Betella N; Diabetic Ketoacidosis: Considerations and Residual Controversies in Management After the 2024 ADA, EASD, JBDS, AACE, and DST Joint Consensus. Endocr Metab Immune Disord Drug Targets. 2025.
Go to original source... - Su D, Li J, Guo M, Clinical Analysis of Electrolyte Disorders in Patients with Diabetic Ketoacidosis. Clin Lab. 2021;Jan 1:67(1).
Go to original source...
Go to PubMed... - Dhatariya KK; Joint British Diabetes Societies for Inpatient Care. The management of diabetic ketoacidosis in adults-An updated guideline from the Joint British Diabetes Society for Inpatient Care. Diabet Med. 2022;39(6):e14788.
Go to original source...
Go to PubMed... - Glaser N, Fritsch M, Priyambada L, ISPAD clinical practice consensus guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2022; 23(7):835-856.
Go to original source...
Go to PubMed... - Engwerda E, van den Berg M, Blans M; Efficacy and safety of a phosphate replacement strategy for severe hypophosphatemia in the ICU. Neth J Med. 2018 Dec;76(10):437-441. PMID: 30569887.
- Geerse DA, Bindels AJ, Kuiper MA Treatment of hypophosphatemia in the intensive care unit: a review. Crit Care. 2010;14(4):R147.
Go to original source... - Anů M, Meisnerová E, Dvořáková J, Masteiková R. Enterální a parenterální substituce sloučeninami fosforu pohledem farmaceuta. Praktické lékárenství. 2010; 6(4):187-189.
- Umpierre, GE., et al. Hyperglycemic crises in adults with diabetes: a consensus report. Diabetes Care, 2024
Go to original source...
Go to PubMed...




