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November 1981

Glucose-Induced Hyperkalemia in Diabetic Subjects

Arch Intern Med. 1981;141(12):1721-1722. doi:10.1001/archinte.1981.00340130159039

To the Editor.  —We read with interest the article of Nicolis et al in the Archives (1981;141:49-53) on glucose-induced hyperkalemia (GIH). Their studies showed that aldosterone deficiency is not necessarily required for GIH to be present. They found, as we have also reported in a nondiabetic renal patient with a suppressed renin-aldosterone system,1 that during GIH, a qualitatively appropriate increase in the plasma aldosterone level occurs. However, "no quantitative comparison can be made with the aldosterone response of normal sub 0.6 0.4 0.2 0 o E 6 △ Nondiabetics ○ Diabetics • Diabetics + 50 mg of Desoxycorticosterone Glucoside Minutes 30 60 120 Effects on serum potassium and blood glucose levels of 100 g of glucose administered orally in 15 subjects without diabetes and in three diabetics with normal aldosterone levels both without and after pharmacologic dose of desoxycorticosterone. Reversal of the paradoxical glucoseinduced hyperkalemia after desoxycorticosterone administration was striking.

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