Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Glucose-Induced Hyperkalemia in Diabetic Subjects

Glucose-Induced Hyperkalemia in Diabetic Subjects Abstract • Four insulin-deprived patients with diabetes mellitus and normal baseline potassium and aldosterone levels became hyperkalemic when given 100 g of glucose orally. The increases in plasma potassium concentrations averaged 1.3 mEq/L (range, 0.7 to 1.8 mEq/L) and were accompanied by increases in plasma aldosterone level. Four other insulin-deprived diabetics had normal plasma potassium and aldosterone responses when given 50 mEq of potassium chloride orally. These findings suggest that glucose-induced hyperkalemia is not infrequent in diabetics and that it is not usually associated with hypoaldosteronism. The acute suppression of aldosterone biosynthesis with aminoglutethimide did not lead to increased plasma potassium levels following oral potassium loads. This suggests that the acute responses of aldosterone to potassium loads may not be important in preventing postprandial hyperkalemia. (Arch Intern Med 141:49-53, 1981) References 1. Goldfarb S, Strunk B, Singer I, et al: Paradoxical glucose induced hyperkalemia: Combined aldosterone and insulin deficiencies. Am J Med 59:744-750, 1975.Crossref 2. Goldfarb S, Cox M, Singer I, et al: Acute hyperkalemia induced by hyperglycemia: Hormonal mechanisms. Ann Intern Med 84:426-432, 1976.Crossref 3. Perez GO, Lespier L, Knowles R, et al: Potassium homeostasis in chronic diabetes mellitus. Arch Intern Med 137:1018-1022, 1977.Crossref 4. Viberti GC: Glucose-induced hyperkalemia: A hazard for diabetics? Lancet 1:690-691, 1978.Crossref 5. Varsano-Aharon N, Ulick S: A simplified radioimmunoassay of plasma aldosterone. J Clin Endocrinol Metab 37:372-379, 1973.Crossref 6. Ito T, Woo J, Haning R, et al: A radioimmunoassay for aldosterone in human peripheral plasma including a comparison of alternate techniques. J Clin Endocrinol Metab 34:106-112, 1972.Crossref 7. Farber SJ, Pellegrino ED, Conan NJ, et al: Observations on the plasma K level of man. Am J Med Sci 221:678-687, 1951.Crossref 8. Seldin DW, Tarail R: Effect of hypertonic solutions on metabolism and excretion of electrolytes. J Clin Invest 159:160-174, 1949. 9. Zierler KL: Effect of insulin on K efflux from rat muscle in the presence and absence of glucose. Am J Physiol 198:1066-1070, 1960. 10. Zerbe R, Vinicor F, Robertson GL: Hypertonic glucose and saline have similar hyperkalemic effects in diabetes, abstracted. Clin Res 27:263, 1979. 11. Cox M, Sterns RH, Singer I: The defense against hyperkalemia: The roles of insulin and aldosterone. N Engl J Med 299:525-531, 1978.Crossref 12. Knochel JP: Role of glucoregulatory hormones in potassium homeostasis. Kidney Int 11:443-452, 1977.Crossref 13. DeFronzo RA, Sherwin RS, Felig P, et al: Nonuremic diabetic hyperkalemia: Possible role of insulin deficiency. Arch Intern Med 137:842-843, 1977.Crossref 14. Ammon RA, May WS, Nightingale SD: Glucose-induced hyperkalemia with normal aldosterone levels. Ann Intern Med 89:349-351, 1978.Crossref 15. Himathongkam T, Dluhy RG, Williams GH: Potassium, aldosterone, renin interrelationships. J Clin Endocrinol Metab 41:153-159, 1975.Crossref 16. Ross EJ, Reddy WJ, Rivera A, et al: Effects of intravenous infusions of dl-aldosterone acetate on sodium and potassium excretion in man. J Clin Endocrinol Metab 19:289-296, 1959.Crossref 17. Alexander EA, Levinsky NG: An extrarenal mechanism of K adaptation. J Clin Invest 47:740-748, 1968.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Glucose-Induced Hyperkalemia in Diabetic Subjects

Loading next page...
 
/lp/american-medical-association/glucose-induced-hyperkalemia-in-diabetic-subjects-0tsMBIAE7F
Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1981.00340010045012
Publisher site
See Article on Publisher Site

Abstract

Abstract • Four insulin-deprived patients with diabetes mellitus and normal baseline potassium and aldosterone levels became hyperkalemic when given 100 g of glucose orally. The increases in plasma potassium concentrations averaged 1.3 mEq/L (range, 0.7 to 1.8 mEq/L) and were accompanied by increases in plasma aldosterone level. Four other insulin-deprived diabetics had normal plasma potassium and aldosterone responses when given 50 mEq of potassium chloride orally. These findings suggest that glucose-induced hyperkalemia is not infrequent in diabetics and that it is not usually associated with hypoaldosteronism. The acute suppression of aldosterone biosynthesis with aminoglutethimide did not lead to increased plasma potassium levels following oral potassium loads. This suggests that the acute responses of aldosterone to potassium loads may not be important in preventing postprandial hyperkalemia. (Arch Intern Med 141:49-53, 1981) References 1. Goldfarb S, Strunk B, Singer I, et al: Paradoxical glucose induced hyperkalemia: Combined aldosterone and insulin deficiencies. Am J Med 59:744-750, 1975.Crossref 2. Goldfarb S, Cox M, Singer I, et al: Acute hyperkalemia induced by hyperglycemia: Hormonal mechanisms. Ann Intern Med 84:426-432, 1976.Crossref 3. Perez GO, Lespier L, Knowles R, et al: Potassium homeostasis in chronic diabetes mellitus. Arch Intern Med 137:1018-1022, 1977.Crossref 4. Viberti GC: Glucose-induced hyperkalemia: A hazard for diabetics? Lancet 1:690-691, 1978.Crossref 5. Varsano-Aharon N, Ulick S: A simplified radioimmunoassay of plasma aldosterone. J Clin Endocrinol Metab 37:372-379, 1973.Crossref 6. Ito T, Woo J, Haning R, et al: A radioimmunoassay for aldosterone in human peripheral plasma including a comparison of alternate techniques. J Clin Endocrinol Metab 34:106-112, 1972.Crossref 7. Farber SJ, Pellegrino ED, Conan NJ, et al: Observations on the plasma K level of man. Am J Med Sci 221:678-687, 1951.Crossref 8. Seldin DW, Tarail R: Effect of hypertonic solutions on metabolism and excretion of electrolytes. J Clin Invest 159:160-174, 1949. 9. Zierler KL: Effect of insulin on K efflux from rat muscle in the presence and absence of glucose. Am J Physiol 198:1066-1070, 1960. 10. Zerbe R, Vinicor F, Robertson GL: Hypertonic glucose and saline have similar hyperkalemic effects in diabetes, abstracted. Clin Res 27:263, 1979. 11. Cox M, Sterns RH, Singer I: The defense against hyperkalemia: The roles of insulin and aldosterone. N Engl J Med 299:525-531, 1978.Crossref 12. Knochel JP: Role of glucoregulatory hormones in potassium homeostasis. Kidney Int 11:443-452, 1977.Crossref 13. DeFronzo RA, Sherwin RS, Felig P, et al: Nonuremic diabetic hyperkalemia: Possible role of insulin deficiency. Arch Intern Med 137:842-843, 1977.Crossref 14. Ammon RA, May WS, Nightingale SD: Glucose-induced hyperkalemia with normal aldosterone levels. Ann Intern Med 89:349-351, 1978.Crossref 15. Himathongkam T, Dluhy RG, Williams GH: Potassium, aldosterone, renin interrelationships. J Clin Endocrinol Metab 41:153-159, 1975.Crossref 16. Ross EJ, Reddy WJ, Rivera A, et al: Effects of intravenous infusions of dl-aldosterone acetate on sodium and potassium excretion in man. J Clin Endocrinol Metab 19:289-296, 1959.Crossref 17. Alexander EA, Levinsky NG: An extrarenal mechanism of K adaptation. J Clin Invest 47:740-748, 1968.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1981

References