Hyperkalemia is a serious problem caused by diabetes.

This is one of the most common electrolyte imbalances experienced by people with kidney disease, or diabetic nephropathy. Blood potassium levels are elevated and the body is not able to eliminate or bring back into balance the excess potassium on its own.

This electrolyte imbalance can cause weakness in muscles. Hyperkalemia can cause a fatal heart rhythm or cause the need for a transplant.

Hyperkalemia is well understood, but recognizing and treating it is difficult.

Diabetes is linked to hyperkalemia.

Nephropathy refers to the deterioration of kidney function. When left untreated it leads to end-stage renal disease (ESRD), more commonly referred to as kidney failure, and death.

Difficult to identify in its early stages, nephropathy shows few symptoms that clearly point to kidney problems. It’s most commonly diagnosed using a combination of blood and urine lab tests that measure glomerular filtration rate (GFR) and the presence of albumin, a protein found in the urine in the early stages of nephropathy.

Compromised kidney function disrupts the body’s ability to eliminate extra potassium from the bloodstream. When this happens the body can experience an electrolyte imbalance and critically important functions are impaired, like waste elimination and blood pressure regulation.

The symptoms of an electrolyte imbalance can vary. They include:

  • There is pain in the muscles.
  • It is a symptom of cramping.
  • The heart is racing.
  • The breath was very thin.

The symptoms can be hard to identify, or they could come on suddenly and be very severe.

The effects of hyperkalemia can be present in people with mild to moderate kidney disease. But these effects are more likely to become more severe and life threatening as kidney problems progress.

People with diabetes are at higher risk for hyperkalemia. People with diabetes need to manage other risk factors.

People with diabetes are more likely to have other problems.

Medications

Certain diabetes medications can have a side effect on the body. These include:

  • A drug called ACE.
  • Angiotensin-receptor blockers are used to block blood vessels.
  • There areblockers.
  • NSAID is nonsteroidal anti- inflammatory drugs. These are often taken over the counter for pain relief and carry a warning that long use can lead to problems with the kidneys.

High glucose levels

The elevated glucose levels that characterize diabetes also disrupt the body’s ability to balance electrolyte levels. Potassium normally is stored in cells throughout the body.

“When the levels of the blood are high, the cells can’t get the essential mineral, called potassium. The body needs the help of the hormone silygin to get the cells to move.”

Delivering short-acting regular insulin (insulin R) intravenously is accepted as an effective treatment for hyperkalemia. IV regular insulin lowers serum potassium quickly by opening up pathways for potassium to move out of the bloodstream and into cells.

However, this treatment brings with it the risk of experiencing hypoglycemia (low blood glucose) or hypokalaemia (low potassium). To avoid these risks, dextrose (sugar) might be administered along with the regular insulin or a smaller dose of insulin R administered reducing its overall effect.

There are a number of treatment options for hyperkalemia.

IV regularinsulin is the most likely treatment in an emergency. If the person is also suffering from kidneys failure, then it is possible to have a transplant.

Treatments are available in addition to the emergency measures.

  • The risk of ventricular fibrillation is reduced by calcium.
  • Enhancing the pH and easing the potassium into cells are some of the alkalinizing agents.
  • The adrenergic agonists promote the movement of the potassium into the cells.
  • The elimination of potassium through urine is promoted by the use of diuretics.
  • The elimination of the excretion of the mineral, kantha, is promoted by the use of binders.

As a protective measure, dapagliflozin (a SGLT2 inhibitor) may be helpful to people experiencing moderately impaired kidney function. It acts as an osmotic diuretic, producing more urine and encouraging elimination.

There are effective treatments for diabetes after a diagnosis. When hyperkalemia is detected early, it is possible to get medical attention and make a full recovery.

Even after reestablishing potassium homeostasis in the body, actively managing kidney health and potassium levels on an ongoing basis will be needed. This may include making dietary changes and avoiding medications that are linked to a higher risk of kidney damage or hyperkalemia, along with managing glucose levels.

Hyperkalemia is a serious condition. The risk of serious outcomes is high for people with diabetes. It is important to know the signs of hyperkalemia. Understanding the positive effect on managing diet, medication, and health can help reduce this risk.