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Effect of experimental potassium deficiency on glucose and insulin metabolism

  • John W. Rowe
    Correspondence
    Address reprint requests to Dr. John W. Rowe at the Department of Medicine, Beth Israel Hospital, 330 Brookline Avenue, Boston, Mass. 02215.
    Affiliations
    Gerontology Division, Beth Israel Hospital, Harvard Medical School, Boston, Mass.USA

    Thorndike Laboratory, Beth Israel Hospital, Harvard Medical School, Boston, Mass.USA.

    the Clinical Physiology Branch, Gerontology Research Center, National Institute on Aging, National Institutes of Health, Baltimore City Hospitals, Baltimore, Md.USA
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  • Jordan D. Tobin
    Affiliations
    Gerontology Division, Beth Israel Hospital, Harvard Medical School, Boston, Mass.USA

    Thorndike Laboratory, Beth Israel Hospital, Harvard Medical School, Boston, Mass.USA.

    the Clinical Physiology Branch, Gerontology Research Center, National Institute on Aging, National Institutes of Health, Baltimore City Hospitals, Baltimore, Md.USA
    Search for articles by this author
  • Robert M. Rosa
    Affiliations
    Gerontology Division, Beth Israel Hospital, Harvard Medical School, Boston, Mass.USA

    Thorndike Laboratory, Beth Israel Hospital, Harvard Medical School, Boston, Mass.USA.

    the Clinical Physiology Branch, Gerontology Research Center, National Institute on Aging, National Institutes of Health, Baltimore City Hospitals, Baltimore, Md.USA
    Search for articles by this author
  • Reubin Andres
    Affiliations
    Gerontology Division, Beth Israel Hospital, Harvard Medical School, Boston, Mass.USA

    Thorndike Laboratory, Beth Israel Hospital, Harvard Medical School, Boston, Mass.USA.

    the Clinical Physiology Branch, Gerontology Research Center, National Institute on Aging, National Institutes of Health, Baltimore City Hospitals, Baltimore, Md.USA
    Search for articles by this author
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      Abstract

      Disturbances in glucose and insulin metabolism frequently accompany a variety of clinical states associated with potassium deficiency. The exact role of the potassium deficit and the mechanism of its effect are in doubt. The glucose-clamp technique was therefore employed to study glucose and insulin metabolism in 7 normal young male subjects before and after induction of potassium depletion. The clamp technique places the blood glucose concentration under the investigator's control. Under the conditions of steady state hyperglycemia (125 mg/dl above basal for 2 hr) it provides quantification of (1) pancreatic beta cell sensitivity to glucose (plasma insulin response), (2) glucose tolerance (glucose metabolized), and (3) tissue sensitivity to insulin (glucose metabolized/insulin response). Potassium deficiency was induced during a 7–8 day period of a weight-maintaining diet containing 40 meq potassium and at least 150 g carbohydrate, along with the administration of 60 g Na polystyrene sulfonate daily. Paired analysis showed a significant decline in the amount of glucose metabolized from pre- to postdepletion (−27.4 ± 4.5%, p < 0.01). This decline in carbohydrate tolerance was associated with a significant decrease in plasma insulin response to sustained hyperglycemia (−26% ± 6.9%, p < 0.02). Potassium depletion had no effect on tissue sensitivity to insulin (+1.7 ± 7.8%). The degree of potassium depletion as estimated by change in total body 40K ranged from 1.0% to 8.4% and correlated with the decrease in insulin response (r = 0.78, p < 0.05). This study demonstrates that potassium depletion causes glucose intolerance, which is associated with impaired insulin secretion.
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      References

        • Conn JW
        Hypertension, the potassium ion and impaired carbohydrate tolerance.
        N Engl J Med. 1965; 273: 1135-1143
        • Conn HO
        Cirrhosis and diabetes IV: Effect of potassium chloride administration on glucose and insulin metabolism.
        J Med Sci. 1970; 259: 394-404
        • Gorden P
        • Sherman BM
        • Simopoulos AP
        Glucose intolerance with hypokalemia, an increased proportion of circulating proinsulin-like component.
        J Clin Endocrinol Metab. 1972; 34: 235-240
        • Rapoport MI
        • Hurd HF
        Thiazide-induced glucose intolerance treated with potassium.
        Arch Intern Med. 1964; 113: 405-408
        • Gorden P
        Glucose intolerance with hypokalemia: Failure of short-term potassium depletion in normal subjects to reproduce the glucose and insulin abnormalities of clinical hypokalemia.
        Diabetes. 1973; 22: 544-551
        • Delwaide PA
        Body potassium measurements by whole-body counting: Screening of patient populations.
        J Nucl Med. 1973; 14: 40-48
        • McGuire EAH
        • Helderman JH
        • Tobin JD
        • et al.
        Effects of arterial versus venous sampling on analysis of glucose kinetics in man.
        J Appl Physiol. 1976; 41: 565-573
        • DeFronzo R
        • Tobin JD
        • Andres R
        Glucose clamp technique: A method for quantifying insulin secretion and resistance.
        Am J Physiol. 1979; 237: E214-E223
        • Insel PA
        • Liljenquist JE
        • Tobin JD
        • et al.
        Insulin control of glucose metabolism in man.
        J Clin Invest. 1975; 55: 1057-1066
        • Morgan CR
        • Lazarow A
        Immunoassay of insulin—two antibody system. Plasma insulin levels of normal, subdiabetic and diabetic rats.
        Diabetes. 1963; 12: 115-126
        • Sagild UV
        • Anderson J
        • Andreasen PB
        Glucose tolerance and insulin responsiveness in experimental potassium depletion.
        Acta Scand. 1961; 169: 243-251
        • Gomez M
        • Curry DL
        Potassium stimulation of insulin release by the perfused rat pancreas.
        Endocrinology. 1973; 92: 1126-1134