MEDICALElectrolyte correctionHealth Calculator
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Sodium Correction for Hyperglycemia

Hyperglycemia dilutes sodium—each 100 mg/dL glucose rise lowers Na by 1.6-2.4 mEq/L. Corrected sodium predicts what Na will be when glucose normalizes.

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Katz 1.6 mEq/L per 100 mg/dL Hillier 2.4 for severe hyperglycemia Max correction rate 10-12 mEq/L/24h

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Why: All DKA and HHS patients need corrected sodium to guide fluid management and predict Na trajectory.

How: Katz (1.6) for glucose <400; Hillier (2.4) for >400. Corrected Na = Measured Na + Factor × (Glucose - 100) / 100.

Katz 1.6 mEq/L per 100 mg/dLHillier 2.4 for severe hyperglycemia
Sources:ADA DKA/HHS Guidelines

Run the calculator when you are ready.

Calculate Corrected SodiumUse the calculator below to check your health metrics

Normal Glucose Reference

Na 140, Glucose 100

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DKA - Moderate Hyperglycemia

Na 128, Glucose 400 mg/dL

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HHS - Severe Hyperglycemia

Na 125, Glucose 900 mg/dL

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Pseudohyponatremia - Lipids

Severe hypertriglyceridemia

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Pseudohyponatremia - Protein

Severe hyperproteinemia

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Extreme Hyperglycemia

Na 118, Glucose 1500 mg/dL

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Clinical Scenarios — Click to Load

Sodium & Glucose

Laboratory sodium
Serum glucose

Correction Parameters

Pseudohyponatremia (Optional)

For lipid artifact
For protein artifact
sodium_correction.sh
CALCULATED
$ calc_corrected_na --measured=130 --glucose=400
Measured Na
130
Corrected Na
134.8
Correction
+4.8 mEq/L
Status
Mild Hyponatremia
Share:
Sodium Correction for Hyperglycemia
True hyponatremia exists
134.8 mEq/L
📊 Correction: +4.8 mEq/L💧 Osmolality: 287 mOsm/kg
numbervibe.com/calculators/health/sodium-correction-calculator

Sodium Comparison

Expected Na During Treatment

Calculation Breakdown

Step 1: Glucose Excess
Formula: ext{Glucose} - 100 ext{mg}/ ext{dL}
Calculation: 400 - 100
Result: 300 mg/dL
Step 2: Correction Factor
Formula: Katz = 1.60 mEq/L per 100 mg/dL
Calculation: Using Katz
Result: Factor = 1.60
Step 3: Sodium Correction
Formula: ext{Factor} imes ( ext{Glucose} ext{Excess} / 100)
Calculation: 1.60 × (300 / 100)
Result: +4.8 mEq/L
Step 4: Corrected Sodium
Formula: ext{Measured} ext{Na} + ext{Correction}
Calculation: 130 + 4.8
Result: 134.8 mEq/L

Recommendations

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Monitor sodium frequently during glucose correction

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Expect sodium to rise ~1.6-2.4 mEq/L for each 100 mg/dL glucose decrease

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Evaluate for true causes of hyponatremia after glucose normalizes

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Recheck electrolytes every 2-4 hours during active treatment

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Aim for sodium correction rate ≤10-12 mEq/L per 24 hours

For informational purposes only — not medical advice. Consult a healthcare professional before acting on results.

🏥 Health Facts

📊

Corrected Na predicts sodium when glucose normalizes

— Critical care

⚠️

Max correction rate 10-12 mEq/L per 24h

— Safety guidelines

📋 Key Takeaways

  • • Hyperglycemia dilutes sodium—each 100 mg/dL glucose rise lowers Na by 1.6-2.4 mEq/L
  • • Use Katz (1.6) for glucose <400 mg/dL; Hillier (2.4) for >400 mg/dL
  • • Corrected sodium predicts what Na will be when glucose normalizes—guides fluid therapy
  • • Corrected Na >145 indicates true hypernatremia (severe free water deficit)
  • • Sodium will rise as glucose falls during DKA/HHS treatment—expected, not overtreatment

💡 Did You Know?

💧High glucose draws water into vascular space, diluting sodium. Water shifts reverse as glucose normalizes.Source: Physiology
📊Hillier formula (2.4) is more accurate at very high glucose levels based on 2009 physiological studiesSource: Critical Care
🏥All DKA and HHS patients need corrected sodium to guide fluid management and predict Na trajectorySource: ADA Guidelines
⚠️Pseudohyponatremia from severe hyperlipidemia or paraproteinemia is a lab artifact—direct ISE avoids itSource: Lab Medicine
📈Aim for sodium correction rate ≤10-12 mEq/L per 24 hours to avoid osmotic demyelinationSource: Safety Guidelines
💉Corrected Na >145: use more hypotonic fluids. Corrected Na normal: NS then half-NS as glucose falls.Source: Fluid Strategy

📖 How Sodium Correction Works

Hyperglycemia causes water to shift from intracellular to extracellular space, diluting serum sodium. Corrected sodium estimates true sodium.

Step 1: Glucose Excess

Glucose Excess = Glucose - 100 mg/dL. This drives the dilutional effect.

Step 2: Apply Correction Factor

Katz: 1.6 mEq/L per 100 mg/dL. Hillier: 2.4 mEq/L. Adaptive: 1.6-2.4 based on glucose level.

Step 3: Corrected Sodium

Corrected Na = Measured Na + (Factor × Glucose Excess / 100). Predicts Na when glucose normalizes.

🎯 Expert Tips

💡 Rising Sodium is Expected

During DKA/HHS treatment, sodium should rise as glucose falls. This is normal, not overtreatment.

💡 True Hypernatremia

Corrected Na >145 indicates severe free water deficit. Use more hypotonic fluids.

💡 Monitor Frequently

Check sodium every 2-4 hours during DKA/HHS. Adjust fluids based on trajectory.

💡 Correction Rate

Sodium correction should not exceed 10-12 mEq/L per 24 hours to avoid osmotic demyelination.

⚖️ Formula Comparison

FormulaCorrection FactorBest For
Katz1.6 mEq/L per 100 mg/dLGlucose <400 mg/dL
Hillier2.4 mEq/L per 100 mg/dLGlucose >400 mg/dL
Adaptive1.6-2.4 (glucose dependent)All levels

❓ Frequently Asked Questions

Katz or Hillier formula?

Use Katz (1.6) for glucose <400 mg/dL. Use Hillier (2.4) for glucose >400 mg/dL. Adaptive transitions between them.

Why does sodium rise during DKA treatment?

As glucose falls, water shifts back into cells, concentrating serum sodium. This is expected and predicted by corrected sodium.

What if corrected sodium is high?

Corrected Na >145 indicates underlying hypernatremia—significant free water deficit. More aggressive hypotonic fluid replacement needed.

What is pseudohyponatremia?

Lab artifact from severe hyperlipidemia or hyperproteinemia. Direct ion-selective electrode measurement avoids it. Does not cause symptoms.

How fast should glucose be corrected?

Target 50-75 mg/dL per hour. Faster correction can lead to cerebral edema, especially in children.

When to worry about osmotic demyelination?

Risk increases if sodium rises >10-12 mEq/L in 24 hours, especially with chronic hyponatremia, malnutrition, or hypokalemia.

📊 Sodium Correction by the Numbers

1.6
Katz Factor
2.4
Hillier Factor
10-12
Max mEq/L/24h
135-145
Normal Na

⚠️ Disclaimer: This calculator is for educational purposes only. Electrolyte management in DKA/HHS requires clinical judgment. All treatment decisions should involve healthcare providers.

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