According to a 2011 national diabetes fact sheet from the Centers for Disease Control and Prevention, over 25 million people, or 8.3 percent of the United States population, have diabetes. Diabetes is the condition that results from the lack of insulin production or from insulin resistance; in diabetes, there is abnormal metabolism of glucose, which results in elevated blood glucose levels. Diabetes is associated with dysregulation of potassium, but several studies suggest that hypokalemia may mediate the development of diabetes.
Hypokalemia and Insulin
According to "Davidson's Principles & Practice of Medicine," hypokalemia, or low blood potassium, is defined as blood potassium levels below 3.5 millimoles per liter, or mmol/L, of blood. Potassium facilitates the function of insulin in the delivery of glucose to cells; when insulin binds to its receptors on the cell membrane, it causes potassium to flow into the cells. As levels of insulin increase in the blood, more potassium is driven into cells; therefore, hyperinsulinemia, or high blood insulin, is commonly associated with hypokalemia.
Hypokalemia and Diabetes Studies
Since a clear relationship exists between insulin and potassium, researchers have speculated the possibility of potassium's involvement in the development of diabetes. According to a 2008 article in the journal "Hypertension," several studies have collectively demonstrated a strong inverse relationship between blood glucose levels and potassium levels during the use of thiazides diuretics; therefore, as potassium levels decrease, blood glucose levels should increase. This inverse relationship between glucose and potassium, concurs with the notion that total body potassium has a role in determining person's sensitivity to insulin.
Causes of Hypokalemia
In diabetics, excessive use of human insulin is associated with hypokalemia; those with low blood glucose and hypokalemia should avoid using human insulin. Other causes of hypokalemia include excessive release of aldosterone -- a steroid hormone produced by the adrenal glands -- excess vomiting, diarrhea and use of laxatives.
Symptoms of hypokalemia
Potassium is important to the function of nerves, muscles and heart; hypokalemia can result in dysfunction of organs that require potassium. When potassium levels drop below 3.5 mmol/L, a person can experience tiredness and weakness of the muscles. In hypokalemia, heart dysfunction is the most bothersome because it can result in severely low blood pressure, which reduces the flow of oxygen-rich blood to organs of the body; hypokalemia can cause serious arrhythmias, or dysregulation of heart rhythm, thereby making the heart an ineffective pump.
- "Hypertension"; Hypertension, Hypokalemia, and Thiazide-Induced Diabetes; Rajiv Agarwal; 2008
- Centers for Disease Control and Prevention: 2011 National Diabetes Fact Sheet
- "Davidson's Principles & Practice of Medicine; Nicholas A. Boon; 2006
- Merck Manuals Online Medical Library; Disorders of Potassium Concentration; May 2009