February 5, 2007
Question from India:
One indicated action of insulin is increased potassium uptake; it forces cells to absorb serum potassium. A lack of insulin inhibits absorption. Does it indicate that hyperglycemia causes decreased uptake of potassium or causes increased efflux of potassium by extravascular cells? As such, can a hyperglycemic person lose more and more potassium in urine and remain somewhat deficient in potassium on an intracellular level? Potassium is also related to sodium, magnesium, and calcium homeostatis as higher than normal potassium in urine also indicates low magnesium levels. If the loss of potassium and magnesium in urine is excessive, can it be the reason for overeating common in diabetics, which may be meant to compensate lost potassium and magnesium in urine while glucose and other nutrients are also taken in excessively and unnecessarily with overeating?
Probably not. However, I have clearly observed patients with poor control of their blood sugars who have elevated potassium levels. This is the antithesis of what you mentioned about having insulin move potassium intracellularly.