Diabetes & Potassium Levels

Diabetes results from a disordered metabolism of glucose, thereby, causing markedly elevated blood glucose levels. Diabetes is commonly associated with abnormal blood potassium level. Abnormalities in blood potassium levels are related to high blood glucose, acidity of blood and insulin deficiency.

High Blood Glucose

Water is attracted to glucose; elevated blood glucose in the blood results in the redistribution of water from the cells to the blood, thereby, resulting in increased blood volume. Increased blood volume results in increased urine formation. Since potassium is constantly lost in urine, increased urination, results in increase potassium loss in a person with normal kidneys. High blood glucose causes more potassium to leave the cell and enter the blood. In a person with impaired kidney function, high blood glucose can lead to high blood potassium since urine output is decreased in renal failure.

Blood Acidity

In diabetes, the decreased ability to metabolize glucose, forces the body to use proteins and fats as alternative sources of energy. Lipolysis, or the breakdown of fat to release energy, results in the formation of ketones; ketones are acidic byproducts of lipid breakdown and when present in excess, can acidify the blood. Acidic blood results in the shifting of potassium from cells into the blood.

Insulin Insufficiency

Insulin is needed for a cell to internalize and use glucose. Insulin interacts with receptors on the cell membrane. For insulin to transport glucose into the cell, it needs potassium. Potassium is driven into the cell together with glucose by insulin. Insulin removes potassium from the blood; when insulin is deficient, potassium increases in the blood.

Management of Diabetes

Hyperkalemia, or high blood potassium, is not usually a problem in the early stages of diabetes, since the kidneys are probably in good condition. Deterioration of the kidneys with advancement of diabetes, increases the chances for developing hyperkalemia. It is, therefore, crucial that a person with diabetes, maintains adequate control of glucose to prevent kidney disease. Diabetes caused by lack of insulin, as opposed to that caused by resistance to insulin, is more likely to cause hyperkalemia since insulin is needed to drive potassium into the cells.