Why extensive lipolysis in diabetic asidosis can result in spuriously low serum na levels?

The very high: Blood sugar levels interfere with the lab determination of sodium producing a low reading.

Different reasons: Lipids are fats & don't mix with water & the sodium dissolved in water. If lipids occupy 10% of the volume of the blood, then sodium will drop by 10% (14 meq/l). When glucose levels are very high, the kidney can't reabsorb glucose or sodium very well from the filtered blood in the urine, and sodium levels drop.