Effects of potassium citrate or potassium chloride in patients with combined glucose intolerance: A placebo-controlled pilot study.
Experimental K(+) depletion reversibly inhibits insulin secretion, while chronic metabolic acidosis decreases insulin sensitivity. We aimed to investigate the effects of potassium supplementation and alkali supplementation in non-acidotic, normokalemic humans with combined glucose intolerance.



In this double-blind, placebo-controlled study in 11 subjects (7 male, 4 female, ages 47-63 years), 90meqs of oral KCl or Kcitrate per day for 2weeks each increased insulin production as measured by homeostasis model assessment Beta [KCl=86 (CI 81-91), Kcitrate=88 (82-94), placebo=78 (73-83)%, p<0.04], but only Kcitrate attenuated insulin resistance as assessed by HOMA-IR (insulin resistance, Kcitrate=2.8 (2.5-3.1), placebo=3.2 (2.9-3.5), p<0.03) and only Kcitrate increased quantitative insulin sensitivity check index (Quicki, Kcitrate=0.355 (0.305-0.405), placebo=0.320 (0.265-0.375) p<0.04). These results were confirmed by independent measurements, i.e. HOMA C-peptide and whole body insulin sensitivity index measured during oral glucose tolerance testing. Kcitrate significantly decreased systolic and diastolic 24-hour ambulatory blood pressures (-4.0 (-3 to -5) and -2.7 (-1.9 to -3.5), respectively as compared to placebo, p<0.02) while KCl was without a significant effect.



K(+) supplementation in the absence of overt K(+) depletion improves beta-cell function in subjects with combined glucose intolerance. The insulin-sensitizing and hypotensive effect, however, depend on citrate as the accompanying anion.
Medizinische Universitätsklinik, Kantonsspital Bruderholz, University of Basel, CH-4101 Bruderholz/Basel Switzerland.
Katrin
K
Conen
Medizinische Universitätsklinik, Kantonsspital Bruderholz, University of Basel, CH-4101 Bruderholz/Basel Switzerland.
Roberto
R
Scanni
Medizinische Universitätsklinik, Kantonsspital Bruderholz, University of Basel, CH-4101 Bruderholz/Basel Switzerland.
Marie-Therese
MT
Gombert
Department of Medicine, University of California San Francisco, San Francisco, CA USA.
Henry N
HN
Hulter
Medizinische Universitätsklinik, Kantonsspital Bruderholz, University of Basel, CH-4101 Bruderholz/Basel Switzerland. Electronic address: Reto.krapf@hirslanden.ch.
Reto
R
Krapf
D000368:Aged; D001786:Blood Glucose; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin; D007333:Insulin Resistance; D008297:Male; D010865:Pilot Projects; D011189:Potassium Chloride / Q000627:therapeutic use*; D019357:Potassium Citrate / Q000627:therapeutic use*
D001786:Blood Glucose; D007328:Insulin; D011189:Potassium Chloride; D019357:Potassium Citrate
Citrate; Combined glucose intolerance; Metabolic acidosis; Potassium; Prediabetes