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Insulin and Potassium

Discussion in 'Parents of Children with Type 1' started by kiwiliz, Sep 7, 2010.

  1. kiwiliz

    kiwiliz Approved members

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    I just read about the little girl who was airlifted with ketoacidosis and it reminded me that one of the pitfalls of insulin is that it causes hypokalemia. From wikipedia.org (refers to the condition in which the concentration of potassium (K+) in the blood is low)

    I read it in the contraindications of a box of insulin, shortly after diagnosis, and have made sure dd has a little banana or tomato every day since. I am sure there are other foods that contain potassium - but I haven't looked them up!:rolleyes:

    Novonordisk:
    I just had a look through wikipedia and was a little taken aback because they say that diabetic ketoacidosis is a common cause of hypokalemia and it only much further down the post that you find this quote;

    This is the thread about the little girl
     
  2. ecs1516

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    orange juice has it too.

    prunes
     
  3. Colleen

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    Hypokalemia is caused by giving the insulin IV not SQ. When you are in DKA the preferred route to bring down the elevated sugar is usually IV. This can cause low potassium. Monitoring of the blood chemistry is done at this time to monitor the pt.
     
  4. kiwiliz

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    Yes - but I also believe that sub cutaneous injections of insulin predispose you to a lack of potassium:

    http://emedicine.medscape.com/article/242008-overview


    http://www.fda.gov/Safety/MedWatch/SafetyInformation/Safety-RelatedDrugLabelingChanges/ucm121754.htm
     
  5. jilmarie

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    Insulin-induced hypokalemia is only a problem when you're treating the high blood sugars that go along with DKA, here's why:

    Normally, the cells in the body have a lot of potassium on the inside and lower levels of potassium on the outside of cells (such as in the blood). When a person goes into DKA, the levels of acid in the blood get much higher than normal. Because both this acid and potassium are positively charged, some of the acid goes into the cells and forces some of the potassium to come into the blood - so during DKA, potassium levels are HIGH. When insulin is given, the acid levels decrease and the potassium goes back into the cells where it belongs, but now the potassium levels are too low - this is hypokalemia. Part of the treatment of DKA involves monitoring the potassium levels after giving insulin and giving extra potassium if they get too low.

    When your DD is taking her normal insulin at home, she doesn't have the extra acid (that she would with DKA), so she isn't at risk for low potassium. The insulin you're giving is simply replacing the insulin that most people's body makes naturally, so there is not a problem with potassium.

    In short, I wouldn't worry about making sure your dd gets extra potassium in her diet unless she likes those foods.
     
  6. kiwiliz

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    Thanks Jilmarie. If you are pumping lots of insulin in because your child is high, but don't have any ketones, is that ever a problem? Would adults who are on a low potassium diet to keep their blood pressure down be more inclined to go into ketoacidosis? I appreciate the answers you have given. Thank you.
     

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