In some sources, what value is used instead of 1.6 mEq/L for correcting sodium in hyperglycemia?

• A. 0.5 mEq/L
• B. 2.0 mEq/L
• C. 3.0 mEq/L
• D. 4.0 mEq/L

Answer: (B)

When glucose is high, water shifts from inside cells into the extracellular space, diluting serum sodium and making it look lower than the true value. To estimate the real sodium level, clinicians add a correction factor for the rise in glucose above normal (about 100 mg/dL). While a common correction uses 1.6 mEq/L per 100 mg/dL, some sources use a larger factor of 2.0 mEq/L per 100 mg/dL. Using the higher factor makes the calculated sodium higher, which can change how you manage fluids and the speed of any correction. For example, if glucose is 300 mg/dL (200 mg/dL above normal), applying the 2.0 factor adds about 4 mEq/L to the measured sodium, versus about 3.2 mEq/L with the 1.6 factor. That difference can influence clinical decisions, especially in balancing osmotic shifts and preventing overly rapid shifts in sodium.