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How Does Insulin Affect Potassium Levels?

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Insulin And Potassium

Insulin has a number of actions on the body besides lowering your blood glucose levels. Insulin suppresses the breakdown and buildup of glycogen, which is the storage form of glucose, it blocks fat metabolism and the release of fatty acids, and it puts potassium into the cells by activating the sodium-potassium cellular channels. Insulin stimulates the uptake of glucose and potassium in all cells of the body but primarily fuels the muscle cells as well as some of the fat cells. In type 2 diabetes or metabolic syndrome (a form of metabolic disease), insulin is not functioning up to its normal level. The cells of the body become resistant to insulin and the blood sugar levels are elevated. The serum potassium (K+) level is a reflection of the total body stores of potassium, although it can be inaccurate in some conditions that affect the distribution of potassium in the body’s cells. The plasma potassium level determines the resting potential of the cells of the body. A person can have low potassium (hypokalemia) or high potassium (hyperkalemia), both of which are asymptomatic conditions that can be serious as they both cause heart arrhythmias. The Relationship between Insulin and Continue reading >>

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  1. Ahmed-USMLE

    What does insulin do to potassium and what does potassium do to insulin secretion is a concept that is frequently tested in USMLE Step 1.
    Let's summarize here and I'd be happy if you enrich this thread with your valuable posts.
    Insulin causes Potassium to shift into the cells thereby decreasing the extracellular K level. That's why insulin is used in the treatment of hyperkalemia.
    Level of Potassium in the serum also affects insulin secretion from the pancreas. Because the beta cells have an ATP dependent K channel which is when closed leads to retained K inside the beta cell which favors depolarization thereby enhancing Calcium mediated release of secretory granules. Therefore, in hyperkalemia more K will enter the beta cell and insulin secretion will increase and conversely in hypokalemia the K ions are more likely to leave the beta cell and so insulin secretion will decrease.

  2. syedaanaqvi

    thanks..it will help many

  3. DrSeddik

    Thanx for the useful post. I was aware of insulin effect on K but not the reverse.
    In DKA (insulin deficiency) K is shifted extracellularly but is also lost in urine, so the patient's intracellular K is much depleted than the serum test.
    I also find it very useful for the USMLE and real life to know other causes of K intracellular shift (not necessarily loss), these include:
    1- B2 effect: That's why you should check K level after you give multiple doses of bronchodilator to patient in severe asthmatic attack. It's also used in rapid adjunctive treatment of hyperkalemia. B blockers cause hyperkalemia.
    2-Alkalosis: so most of the time you see alkalosis you see hypokalemia in association, exceptions include loss of intestinal fluid (diarrhea, villous adenoma) and RTA types 1 and 2. Alkalosis also increases K excretion. Acidosis cause extracellular K shift.
    3-A very rare disorder that is really not worth mentioning is hypokalemic periodic paralysis.

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