Spironolactone, available as the brand Aldactone, is a prescription medication known as a potassium-sparing diuretic. It causes the kidneys to remove excess water and sodium from the body through urine, but prevents the potassium loss sometimes associated with this action. For a few different reasons, taking Aldactone may be inadvisable if you have diabetes.
Aldactone Uses
The main uses of Aldactone are treating high blood pressure, sometimes in combination with another medication; resolving low potassium levels; and reducing fluid retention caused by health conditions such as congestive heart failure or kidney disease. Aldactone also helps certain patients with a disorder known as hyperaldosteronism, in which the body produces excessive amounts of the hormone aldosterone. This condition can cause high blood pressure and other symptoms.
Aldactone and Hyperkalemia
A risk of taking potassium-sparing diuretics such as Aldactone is hyperkalemia, or high potassium levels. Hyperkalemia can cause muscle paralysis and life-threatening cardiac irregularities. You may be more susceptible to this risk if you have diabetes, and particularly so if you have Type 1 diabetes, uncontrolled diabetes or kidney dysfunction associated with diabetes, known as diabetic nephropathy. This is a major drug-disease interaction, and diabetic patients should avoid taking potassium-sparing diuretics if possible, states Drugs.com.
Research
A study published in the May 2008 issue of "Diabetologia" found one benefit of spironolactone for diabetic patients, along with two disadvantages. The medication was highly effective in reducing high blood pressure in patients for whom other treatment didn't work well. It worsened their blood sugar control, however, and increased levels of the stress hormones cortisol and angiotensin II.
Considerations
If you are diabetic and your doctor decides you should take Aldactone, you will probably need regular blood tests to check your potassium levels. This is particularly important when you first begin therapy or if you change dosage, or if you develop an illness that might affect your kidney function. Even patients not at increased risk for hyperkalemia are typically not supposed to eat a diet rich in potassium or take potassium supplements, according to DailyMed. Consult your doctor or a dietitian about an appropriate diet during Aldactone therapy.
