[Restoration of insulin sensitivity after correction of hypokalemia due to chronic tubulopathy in a diabetic patient].
In a type II diabetic patient presenting with chronic hypokaliemia secondary to a selective renal tubulopathy, insulin sensitivity was explored three times during a euglycemic hyperinsulinemic clamp procedure at two rates of insulin infusion: 1 and 10 mU/kg/min: once before treatment of hypokaliemia and once after successful correction of hypokaliemia with indomethacine or spironolactone. During insulin infusion, a 20% dextrose solution was infused by a Biostator in order to maintain the patient's glycemia at 90 mg/dl. Amounts of glucose infused during the last 20 min of each 2 hour insulin infusion were (at 1 and 10 m/kg/min respectively): before treatment (K+ = 2.7 mmol/l): 2.4 and 8.4 mg/kg/min; after spironolactone (K+ = 3.9 mmol/l): 3.3 and 15.4 mg/kg/min; after indomethacine (K+ = 3.7 mmol/l): 5 and 19 mg/kg/min after stopping drugs (K+ = 2.9 mmol/l): 2.5 and 5.3 mg/kg/min. These data suggest that potassium metabolism plays a critical role in the mechanisms of insulin sensitivity.
Tourniaire
J
J
Clinique Endocrinologique, Hôpital de l'Antiquaille, Lyon.
Bajard
L
L
Harfouch
M
M
Rebattu
B
B
Garrel
D
D
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D003928:Diabetic Nephropathies / Q000150:complications* / Q000188:drug therapy; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007008:Hypokalemia / Q000188:drug therapy* / Q000209:etiology; D007213:Indomethacin / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D011188:Potassium / Q000097:blood; D013148:Spironolactone / Q000627:therapeutic use*
D007328:Insulin; D013148:Spironolactone; D011188:Potassium; D007213:Indomethacin
Normalisation de la sensibilité a l'insuline après correction d'une hypokaliémie par tubulópathie chronique chez une patiente diabétique.