Which electrolyte abnormality might occur following the treatment of diabetic ketoacidosis (DKA) leading to hemolysis?

Following the treatment of diabetic ketoacidosis (DKA), hypophosphatemia is a known electrolyte abnormality that can occur and is particularly important in this context because it can lead to complications such as hemolysis. In the state of DKA, there is typically an increase in the levels of glucose and ketones, leading to metabolic acidosis and various electrolyte imbalances.

When treatment begins, particularly with the administration of insulin and fluids, the body shifts electrolytes as it begins to restore normal metabolic function. Phosphate, which is involved in intracellular energy production and red blood cell function, may move out of the bloodstream into cells. This shift can result in lower serum phosphate levels (hypophosphatemia) and can lead to various clinical issues, including decreased red blood cell production and the potential for hemolysis due to inadequate energy for maintaining cell membrane integrity.

This mechanism highlights the importance of monitoring phosphate levels during the treatment of DKA, as the risk of hemolysis can be a direct consequence of the hypophosphatemia resulting from the treatment process.