Despite being one of the most rigorously studied and best-understood illnesses in the modern world, diabetes continues to be of considerable interest to medical researchers attempting to gain a better understanding of this common illness. Diabetes is a complex disease that involves an interplay between many different bodily processes and chemicals, meaning that there are always new topics for researchers to explore. Research is still being conducted to better expose these interactions in order to more effectively treat diabetes and its harmful health consequences.

One development that researchers are analyzing relates to the various connections that exist between potassium levels and diabetes. Not only has potassium been seen to fluctuate dramatically as a result of untreated diabetes levels, but low potassium levels may even increase the likelihood of developing diabetes in the first place.

What is potassium and why do we need it?

Potassium is a chemical found in the periodic table of elements. It is both a mineral and an electrolyte that exists naturally in the world. Because of its electrolytic properties (meaning that it can conduct electric impulses when dissolved in a solution), potassium plays an important role in the regulation of many bodily functions, including nerve impulses, muscle contractions, proper heart function, and proper endocrine regulation.

What is the connection between diabetes and potassium?

In order to understand the mechanism of a potential connection between potassium and diabetes, it is important to understand the interplay between insulin, glucose, and potassium in the body. Insulin is a hormone, produced in the pancreas, that signals the body’s cells to import glucose from the bloodstream for energy production. Diabetics either don’t produce enough insulin (type 1), or do not respond to insulin (type 2), but both cases result in insufficient glucose being transported into the cells. Accordingly, left untreated, glucose will build up in the bloodstream.

Potassium itself can play a role in insulin production. In fact, its role is so important that a significant link appears to exist between low potassium levels and insufficient insulin production. Studies have observed that diabetes appears to be more prevalent among populations with low levels of potassium. While it is always difficult to draw conclusions about causation from correlations like this, these findings, combined with the knowledge that potassium does play a role in the production of insulin, have led some researchers to hypothesize that there may be a causal connection.

Potassium is normally found within the body’s cells; however, when blood sugar levels become too high, potassium exits the cell and enters the bloodstream, raising blood potassium concentrations to often dangerous levels. Thus, an episode of diabetic hyperglycemia can trigger a chain reaction that ultimately leads to potassium leaching out of cells and into the bloodstream.

Thus, there are two potential connections between potassium and diabetes. Diabetes can cause high levels of potassium due to increased blood sugar levels, and insufficient potassium levels can potentially increase the risk of diabetes in the first place.

What causes low potassium?

The human body is not capable of producing its own supply of potassium. Therefore, it must derive this important nutrient from the foods that it eats. Unfortunately, the modern American diet typically consists of overly processed foods with poor nutritional profiles and contains inadequate amounts of many critical nutrients like Potassium. Insufficient potassium intake through a poor diet is thus a central contributor to low potassium levels in the population.

However, even among people who achieve sufficient potassium intake, low potassium levels can still result from excessive potassium excretion, which can occur for various reasons. For example, certain medications can induce urination (these are known as “diuretics”). Studies have found a direct link between long-term use of certain diuretic medications and low blood potassium levels, which supports the notion that diabetes may result in some cases from low potassium. Excess urination can also result from other causes, like certain medical conditions.

The most severe cause of low potassium levels for diabetics is a diabetes complication called diabetic ketoacidosis. This process occurs mainly in the context of untreated diabetes and involves the body breaking down fats and proteins for energy due to its inability to make use of glucose. Ketones, which are a by-product of this process, build up in the bloodstream and must be flushed out of the system through the kidneys. This flushing induces urination and dehydration, ultimately raising potassium levels. Ketoacidosis is often an emergency and requires urgent treatment. Unfortunately, many of the treatments for ketoacidosis have the same consequence of lowering potassium levels.

What causes high potassium?

As previously mentioned, high blood sugar levels can cause an increase in potassium in the blood. However, this is not the only manner in which uncontrolled diabetes can lead to high blood potassium. Hyperglycemia (high blood sugar) can also be destructive to your kidneys over time. Your kidneys serve many important functions, one of which is to filter excess levels of various chemicals from your bloodstream to maintain normal concentrations. In a healthy person, the kidneys would remove any build-up of potassium (within a reasonable extent) and prevent hyperkalemia. In patients who have suffered kidney damage due to uncontrolled diabetes, however, the kidneys aren’t able to keep up with the levels of potassium in the blood, and potassium, therefore, climbs above what would be considered healthy levels.

How are potassium levels tested?

Even in non-diabetics, but especially in diabetics, potassium levels can be a key indicator of one’s level of overall health. Thus, it is common for doctors to assess potassium levels as part of routine physical check-ups. This is done via a very straightforward and safe procedure where a small amount of blood is drawn from a patient using a syringe and sent to a lab for analysis. The lab will determine the levels of potassium and various other chemical markers in the sample and pass those results along to your doctor, who will then communicate the results and any health implications to you.

If you are diabetic, your doctor may wish to monitor your potassium levels more closely and may insist on more frequent blood tests to ensure that any hypokalemic or hyperkalemic episodes are dealt with quickly to avoid more serious health complications. If you are not having your potassium monitored regularly, you may wish to bring this up with your doctor and suggest more regular sampling in the future.

What is a safe or normal potassium level?

For adults, a safe potassium level is between 3.5 and 5.0 millimoles per liter (mmol/L). When levels go beyond 5.5 mmol/L, hyperkalemia occurs. An individual may require immediate medical attention if levels are above 6.5 mmol/L as they may experience heart problems.

How should you deal with low potassium levels?

The only way to get low potassium levels to within a normal range is to consume more potassium. Depending on how severe the specific episode of hypokalemia is, this may simply involve eating more foods that are rich in this mineral, such as leafy greens, beans, dried fruits, and bananas. Ensuring a proper diet over time may go a long way toward maintaining a healthy potassium profile (as well as a host of other health benefits).

For those with severe deficiencies, a doctor may prescribe a fast-acting potassium supplement that will deliver a concentrated dose of potassium to their system. Over-the-counter dietary supplements can also be used, however, it is always advisable to consult with a physician before adding supplements to your regimen. This is especially true if you are taking supplements to treat a serious condition like diabetes.

Of course, if the hypokalemia is occurring due to other medications or an underlying condition like ketoacidosis, then that condition will need to be addressed directly in addition to ensuring a proper potassium intake.

How should you deal with high potassium levels?

Most healthy individuals need not be overly concerned by the possibility of high potassium levels. While the complications can be serious, hyperkalemia is unlikely to occur in individuals with healthy, functioning kidneys. Even if they consume excessive amounts of potassium, the kidneys will most likely filter out any excess (although consuming unnecessarily high levels of potassium may still not be healthy in the long run).

Individuals who do suffer from hyperkalemia, either due to kidney disease or for other reasons, should seek urgent medical attention. This serious condition will likely require treatment with diuretics, and potentially even dialysis, in order to bring potassium levels within a healthy range before causing harmful effects.

If Hyperkalemia goes untreated, it can lead to acute problems with heart function, muscle function, and other basic bodily functions.

Conclusion

One of the most important things diabetics can do to improve their health outcomes is to be well-informed about their condition. Having more information about diabetes can help diabetics make better choices about nutrition, exercise, medication, and general self-care. While monitoring insulin and carbohydrate intake may be primary concerns for most diabetics, other dietary conditions can play a significant outcome in treatment and are worth paying attention to.

Being aware of the importance of potassium can help diabetics make conscious decisions to monitor their potassium levels and intake, in order to pre-empt or respond effectively to imbalances. Work with your doctor and any other trusted professionals to incorporate potassium monitoring and management into your diabetes management plan.