Prevention of hypokalemia-induced adverse cardiovascular effects in diabetic ketoacidosis: A novel role of the pH-adjusted potassium level

Atif Usman, Norlaila Mustafa, Juman A. Dujaili, Mohd M. Bakry, Siew Hua Gan

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    Hypokalemia is a common observation in diabetic ketoacidosis (DKA) and it is usually associated with insulin deficiency. At first, it hinders the inflow of serum potassium (SK) from extra- to intracellular compartments, which triggers hyperkalemia. In the course of progressive DKA, hyperglycemia and ketosis-induced osmotic diuresis increases potassium excretion, contributing to potassium depletion in intracellular compartments. Insulin deficiency–mediated increased catecholamine levels have a relative effect on potassium concentration via β-adrenoceptors. Moreover, potassium loss is increased, as the degree of acidosis worsens. Acidosis has also been associated with changes on electrocardiography similar to those typical of hypokalemia. However, despite a significant potassium loss, patients with DKA present with various degrees of potassium disturbance on admission, which range from normal kalemia to hyperkalemia.
    Original languageEnglish
    Pages (from-to)1118-1121
    Number of pages4
    JournalPolish Archives of Internal Medicine
    Issue number12
    Publication statusPublished - 22 Dec 2020

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