Paradoxical glucose-induced hyperkalemia. Combined aldosterone-insulin deficiency.

@article{Goldfarb1975ParadoxicalGH,
  title={Paradoxical glucose-induced hyperkalemia. Combined aldosterone-insulin deficiency.},
  author={Stanley Goldfarb and Billy Strunk and Irwin Singer and Martin Goldberg},
  journal={The American journal of medicine},
  year={1975},
  volume={59 5},
  pages={
          744-50
        }
}
Glucose-induced paradoxical hyperkalemia in patients with suppression of the renin-aldosterone system: prevention by sodium depletion
  • J. Radó
  • Medicine, Biology
    Journal of endocrinological investigation
  • 1979
TLDR
The study confirmed the important extrarenal influence of aldosterone in the maintenance of normal potassium level in the hyperosmolal extracellular fluid and showed that high sodium intake may predispose to hazardous hyperkalemia after massive glucose loading in certain nondiabetic patients with liability to suppression of a Aldosterone.
Glucose-induced hyperkalemia in diabetic subjects.
TLDR
Findings suggest that glucose-induced hyperkalemia is not infrequent in diabetics and that it is not usually associated with hypoaldosteronism, and that the acute responses of aldosterone to potassium loads may not be important in preventing postprandial hyperKalemia.
Acute hyperkalemia induced by hyperglycemia: hormonal mechanisms.
TLDR
Two insulin-requiring diabetics with isolated hyporeninemic hypoaldosteronism cpontaneously developed hyperkalemia that was aggravated whenever blood glucose concentration rose, and the need to avoid hyperglycemia in patients with combined insulin and aldosterone deficiency is emphasized.
Effect of insulinopenia and adrenal hormone deficiency on acute potassium tolerance.
TLDR
During acute potassium loading in the rat, insulin and adrenal hormones play an important role in maintaining normal potassium homeostasis, primarily by enhancing potassium uptake by external tissues.
Abnormalities of serum potassium concentration in dialysis-associated hyperglycemia and their correction with insulin: review of published reports
TLDR
The predictors of the decrease in serum K+ during treatment of DH with insulin included the starting serum K+, the decreases in serum values of glucose concentration and tonicity, and the increase in serum total carbon dioxide level, which represents a risk factor for hyperkalemia.
Selective hypoaldosteronism with hyperreninemia in a diabetic patient.
A 62-yr-old diabetic woman exhibited low plasma and urinary aldosterone levels in the face of markedly elevated PRA during the course of nonketoacidotic hyperglycemic precoma with dehydration,
Potassium homeostasis in chronic diabetes mellitus.
TLDR
Diabetic patients with hypoaldosteronism have the potential for severe hyperkalemia should renal or extrarenal mechanisms for potassium homeostasis be challenged by severe acidosis, diminished renal function, marked hyperglycemia, or administration of potassium salts or potassium-sparing diuretics.
Glucose-induced hyperkalemia with normal aldosterone levels. Studies in a patient with diabetes mellitus.
TLDR
Normal aldosterone levels may be insufficient to protect certain diabetic patients from glucose-induced hyperkalemia, and insulin or pharmacologic doses of desoxycorticosterone acetate may be necessary.
Hypertension, hyperkalaemia and abnormalities of the renin-angiotensin system in diabetes mellitus
TLDR
The data indicate that overt hypoaldosteronism is rare among diabetics, and it is shown that plasma angiotensin II falls with improved blood sugar control, and varying control might explain some of the differences between series.
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References

SHOWING 1-10 OF 24 REFERENCES
Hyperkalemia after triamterene in diabetic patients
TLDR
Triamterene caused a minor, reversible increase in serum potassium in all subjects but an increase in fasting blood sugar only in the moderate diabetic patients, and in all groups there was a decline in creatinine clearance after 7 days on triamtercne.
An extrarenal mechanism of potassium adaptation.
TLDR
It is concluded that more rapid lowering of plasma potassium after acute potassium loads by adapted rats is due to enhanced uptake of potassium by one or more tissues stimulated by chronic aldosteronism.
Isolated hypoaldosteronism in adults. A renin-deficiency syndrome.
TLDR
To clarify the mechanism causing isolated hypoaldosteronism in adults, six patients with unexplained hyperkalemia were studied and plasma renin activity (PRA) and concentration were subnormal and failed to increase normally with upright posture and sodium depletion.
Evidence for a role of endogenous insulin and glucagon in the regulation of potassium homeostasis.
TLDR
It is concluded that normally hyperkalemia elicits its own "self-treatment" with endogenous glucose and insulin, insulin increasing K + tolerance and glucagon providing enough glucose to prevent hypoglycemia.
Regulation of plasma aldosterone concentration in anephric man and renal transplant recipients.
TLDR
The effect of supine and upright posture on the concentration of plasma aldosterone, and the possible role of potassium in these responses in the anephric patients, was studied.
Use of spironolactone in renal edema. Effectiveness and association with hyperkalemia.
TLDR
The authors consider spironolactone a useful adjunct in the treatment of patients refractory edema of renal origin, especially in children with the nephrotic syndrome.
The ultrafiltrability of potassium and sodium in human serum.
TLDR
The present investigation comprises an analysis of the diffusibility in vitro of potassium and sodium of sera obtained from a group of normal subjects and an analogous preliminary survey of patients with derangements of electrolyte metabolism.
Renal handling of calcium and phosphate during mineralocorticoid "escape" in man.
TLDR
Renal handling of calcium and phosphate during mineralocorticoid "escape" in man suggests decreased sodium transport in the proximal tubule may be associated with phosphaturia since phosphate is mostly unreabsorbed distally, while decreased sodium reabsorption in the distal tubules may occur with calciuria only.
Succinylcholine-induced hyperkalemia in neuromuscular disease.
The dangerously high levels of plasma potassium known to follow succinylcholine chloride administration in patients with burns or trauma have also been noted in patients with paraplegia or
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