Reversal of glucose-induced hyperkalemia by sodium restriction in normaldosteronemic diabetes: evidence for elevated mineralocorticoid threshold.
Acute glucose loading studies were performed on seven diabetic patients and 18 control subjects. In two normaldosteronemic insulin-dependent diabetic patients during high sodium intake and insulin withdrawal infusion of hypertonic glucose induced a paradoxical elevation of serum potassium levels, while no such abnormalities were found in two other diabetics despite of lower plasma aldosterone levels. Paradoxical glucose-induced hyperkalemia (PGIH) was abolished during insulin withdrawal by sodium restriction associated with a dramatic increase in plasma aldosterone. PGIH was elicited when given 100 g of glucose orally to further three patients with normaldosteronemic diabetes in whom a complete reversal of PGIH was obtained l glucose-induced hyperkalemia (PGIH) was abolished during insulin withdrawal by sodium restriction associated with a dramatic increase in plasma aldosterone. PGIH was elicited when given 100 g of glucose orally to further three patients with normaldosteronemic diabetes in whom a complete reversal of PGIH was obtained l glucose-induced hyperkalemia (PGIH) was abolished during insulin withdrawal by sodium restriction associated with a dramatic increase in plasma aldosterone. PGIH was elicited when given 100 g of glucose orally to further three patients with normaldosteronemic diabetes in whom a complete reversal of PGIH was obtained also by sodium restriction or by administering a large intravenous dose of desoxycorticosterone. These findings suggested an elevated mineralocorticoid threshold level for the normal cellular regulation of potassium distribution in normaldosteronemic diabetics with PGIH.
D000450:Aldosterone / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000378:metabolism*; D004039:Diet, Sodium-Restricted; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced / Q000378:metabolism*; D008901:Mineralocorticoids / Q000378:metabolism*
D001786:Blood Glucose; D008901:Mineralocorticoids; D000450:Aldosterone