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How Does Use Of Insulin Lead To Hypokalemia?

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Practice Essentials

Hypokalemia is generally defined as a serum potassium level of less than 3.5 mEq/L (3.5 mmol/L). Moderate hypokalemia is a serum level of 2.5-3.0 mEq/L, and severe hypokalemia is a level of less than 2.5 mEq/L. Hypokalemia is a potentially life-threatening imbalance that may be iatrogenically induced. Hypokalemia may result from inadequate potassium intake, increased potassium excretion, or a shift of potassium from the extracellular to the intracellular space. Increased excretion is the most common mechanism. Poor intake or an intracellular shift by itself is a distinctly uncommon cause, but several causes often are present simultaneously. (See Etiology.) Gitelman syndrome is an autosomal recessive disorder characterized by hypokalemic metabolic alkalosis and low blood pressure. See the image below. Signs and symptoms Patients are often asymptomatic, particularly those with mild hypokalemia. Symptoms that are present are often from the underlying cause of the hypokalemia rather than the hypokalemia itself. The symptoms of hypokalemia are nonspecific and predominantly are related to muscular or cardiac function. Complaints may include the following: Weakness and fatigue (most commo Continue reading >>

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  1. cybron

    Can you plz tell me why insulin cuZ hypokalemia???

  2. Master shifu

    Insulin results Hypokalemia just by increasing the activity of H*K ATPase pump. So insulin only shifts the K+ from the extracellular compartment to the intracellular compartment, it doesn't decrease the total K+ content of the body........remember it......that's why during management of Hyperkalemia 1st initial therapy is done by giving Insulin + Glucose combination which usually needs 30 minutes to come into action........Hope it helps

  3. cybron

    Thanks master but i heard there is increase activity of Na/K pump not H/K pump..can u plz clarify??
    If H/K pump increases then acid production also increases??

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Potassium Disorders: Hypokalemia And Hyperkalemia

Hypokalemia and hyperkalemia are common electrolyte disorders caused by changes in potassium intake, altered excretion, or transcellular shifts. Diuretic use and gastrointestinal losses are common causes of hypokalemia, whereas kidney disease, hyperglycemia, and medication use are common causes of hyperkalemia. When severe, potassium disorders can lead to life-threatening cardiac conduction disturbances and neuromuscular dysfunction. Therefore, a first priority is determining the need for urgent treatment through a combination of history, physical examination, laboratory, and electrocardiography findings. Indications for urgent treatment include severe or symptomatic hypokalemia or hyperkalemia; abrupt changes in potassium levels; electrocardiography changes; or the presence of certain comorbid conditions. Hypokalemia is treated with oral or intravenous potassium. To prevent cardiac conduction disturbances, intravenous calcium is administered to patients with hyperkalemic electrocardiography changes. Insulin, usually with concomitant glucose, and albuterol are preferred to lower serum potassium levels in the acute setting; sodium polystyrene sulfonate is reserved for subacute treat Continue reading >>

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Popular Questions

  1. cybron

    Can you plz tell me why insulin cuZ hypokalemia???

  2. Master shifu

    Insulin results Hypokalemia just by increasing the activity of H*K ATPase pump. So insulin only shifts the K+ from the extracellular compartment to the intracellular compartment, it doesn't decrease the total K+ content of the body........remember it......that's why during management of Hyperkalemia 1st initial therapy is done by giving Insulin + Glucose combination which usually needs 30 minutes to come into action........Hope it helps

  3. cybron

    Thanks master but i heard there is increase activity of Na/K pump not H/K pump..can u plz clarify??
    If H/K pump increases then acid production also increases??

  4. -> Continue reading
read more close
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Hypokalemia & Diabetes

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. Video of the Day 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, re Continue reading >>

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Popular Questions

  1. standout22

    1 Speaking in terms of relationships, I understand that insulin effects K+. I also understand that with increased insulin production or administration you can have a state of hypokalemia. I just don't understand why, on an intracellular level why and how does insulin production or administration decreased serum K+?
    I appreciate any insight and help!

  2. medicrn16

    Hey Standout...we JUST had a test on this two weeks ago, lol. Hardest dang test I ever took.
    Basically, insulin reduces serum K+ from ECF to ICF mainly because insulin increases the activity of the famous sodium-potassium pump. However, this is only a temporary fix and monitoring for the hypokalemic/hypoglycemic effects would be necessary. You would have to give glucose with the insulin as part of the regimen. It depends on whether the person has an actual total body excess of K+ or the K+ has moved from ICF to ECF as to how well this will work and for how long.
    Causes of movement from ICF to ECF would be tissue damage, acidosis, hyperuricemia, and uncontrolled DM.
    Causes of excess total body K+ would be too much potassium foods, salt substitutes, transfusions of whole blood or PRBCs, and decreased K+ excretion from the kidneys due to K+ sparing diuretics, renal failure, or Addison's disease.
    Hope this helps. For me to pass this test (fluids and electrolytes) I made a chart with similarities/differences. Thank God for this. I escaped the doom of much of the class with a B. Hoo-ray. :wink2:

  3. Daytonite

    potassium levels are decreased by insulin. hypokalemia suppresses insulin release leading to glucose intolerance. this was the best explanation of why it happens that i could find and seems to be tied to atp activity:
    http://www.uhmc.sunysb.edu/internalm...ges/part_d.htm - insulin is the first-line defense against hyperkalemia. a rise in plasma k+ stimulates insulin release by the pancreatic beta cell. insulin, in turn, enhances cellular potassium uptake, returning plasma k+ towards normal. the enhanced cellular uptake of k+ that results from increased insulin levels is thought to be largely due to the ability of insulin to stimulate activity of the sodium potassium atpase located in cell plasma membranes. the insulin induced cellular uptake of potassium is not dependent on the uptake of glucose caused by insulin. insulin deficiency allows a mild rise in plasma k+ chronically and makes the subject liabel to severe hyperkalemia if a potassium load is given. conversely, potassium deficiency may cause decreased insulin release. thus plasma potassium and insulin participate in a feedback control mechanism.

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