What is the mechanism by which diabetes results in hyperkalemia? I'm having a bit of trouble figuring this one out.
Thanx.
Thanx.
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Step I Diabetes and hyperkalemia
Started by Hemichordate
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In the case of diabetic ketoacidosis there is a shift of K+ out of cells and H+ into the cells. A lack of insulin has this same effect as well. In addition to this, diabetic patients on ACE inhibitors will have decreased aldosterone levels and as a result lower K+ excretion.
I'm assuming you mean why does a diabetic in ketoacidosis develop hyperkalemia. The reasoning behind this is essentially a buffering mechanism by the body to decrease protons (i.e., increase the pH) through the exchange of H+ into cells with K+ going out. The issue with this is that once the patient is treated, there is a likelyhood that the K+ will be re-exchanged and K+ will be low in the plasma, leading to a possibility of hypokalemia. You need to give K+ along with insulin and fluids in DKA patients.
