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Recent studies show a connection between potassium levels in the body and the prevalence of diabetes mellitus. Could a potassium-rich diet help to prevent type 2 diabetes from developing?
Here’s everything you need to know about diabetes, potassium, and the relationship between the two.
What is diabetes?
Diabetes is a chronic disease that impacts the body’s ability to convert food into energy. Approximately 34 million Americans, or 1 in 10 Americans, have either Type 1 Diabetes or Type 2 Diabetes.
Diabetes mellitus is the umbrella term for the group of diseases caused by hyperglycemia, or high blood sugar. These include type 1 diabetes, type 2 diabetes, prediabetes, and gestational diabetes. With any form of diabetes, blood glucose levels are too high in the body, resulting in a buildup of sugar in the bloodstream.
What’s the difference between type 1 diabetes and type 2 diabetes?
Type 1 diabetes is a genetic disorder that a person is born with and cannot prevent. Risk factors include having a family history of type 1 diabetes, exposure to viral illnesses, and having autoantibodies (cells that attack the immune system). Children and young adults are most commonly diagnosed with type 1 diabetes.
Type 2 diabetes is a disorder that develops over time and is primarily due to diet. This form of diabetes is preventable. Risk factors include living a sedentary lifestyle and being physically active fewer than three times a week, obesity, and having a family history of type 2 diabetes. Adults ages 45 and older are most commonly diagnosed with type 2 diabetes.
What is potassium?
Potassium is both an essential mineral and electrolyte that the body requires in order to maintain regular fluid levels inside the cells. This nutrient also aids in muscle contraction, blood pressure regulation, and heart rate regulation – the vital functions.
Potassium levels in the blood are measured in millimoles per liter (mmol/L). Blood potassium levels are considered normal between 3.6 and 5.2 millimoles per liter; levels below this range characterize low potassium concentration (hypokalemia), and levels above this range characterize high potassium concentration (hyperkalemia).
Where do we get potassium?
The primary source of potassium is food, especially:
- Fruits: bananas, oranges, kiwis, apricots
- Vegetables: spinach, leafy greens, sweet potato, mushrooms
How much potassium should we consume per day?
Women should consume about 2,600 mg (milligrams) of potassium a day, and men should consume 3,400 mg of potassium a day¹.
The body will use all of the potassium it needs, then will excrete the leftover potassium as urinary waste.
What causes low potassium levels?
Low blood potassium, hypokalemia, may be caused by low dietary potassium intake, increased potassium excretion, laxative use, diarrhea, and high aldosterone levels.
Increased potassium excretion via urine is often caused by diuretic medications, especially thiazide diuretics used to treat high blood pressure and hypertension.
Aldosterone is a steroid hormone secreted by the adrenal glands that serves to regulate blood pressure. If a benign (noncancerous) tumor is present on the adrenal gland, this can cause aldosterone levels to rise – which is called hyperaldosteronism. Hyperaldosteronism causes the body to lose too much potassium and retain too much sodium – leading to hypokalemia.
Evidence from a number of clinical trials, including one by the American Heart Association has also found “an increased incidence of new onset diabetes among patients receiving thiazide diuretics”, tying low potassium levels via use of diuretics to diabetes.
At 2.4 mmol/L, serum potassium concentration is dangerously low and can be life-threatening.
What causes high potassium levels?
High blood potassium, called ‘hyperkalemia’, may be caused by kidney disease, excessive dietary potassium intake, uncontrolled diabetes, dehydration, or severe blood loss.
When blood serum potassium levels are higher than 5.2 mmol/L, this is called hyperkalemia. Hyperkalemia can lead to muscle cramps, serious heart problems, and paralysis.
Using an ACE inhibitor (angiotensin-converting enzyme used to treat high blood pressure and heart failure) also puts a person at a higher risk of developing hyperkalemia.
The Link Between Potassium and Type 2 Diabetes
Insulin is a hormone produced by the pancreas, and it’s responsible for regulating blood sugar levels by transporting glucose (sugar) to the cells in the body. The cells then use glucose for energy, or store it for later use.
Potassium is generally stored in the fluid inside of the cells, but when there’s too much glucose outside of the cells (blood sugar is too high), potassium moves outside of the cell, raising potassium levels in the blood.
Insulin then comes to move glucose into the cell to restore potassium homeostasis, causing potassium levels to drop.
When the body either doesn’t produce enough insulin, doesn’t use insulin properly or is insulin resistant, this causes a buildup of glucose in the bloodstream, since glucose isn’t able to enter the cells without insulin.
People with low potassium levels will release less insulin, which causes higher blood sugar levels, and increases the risk of developing type 2 diabetes. When administering insulin, it’s crucial for healthcare providers to monitor potassium levels.
Diabetic Ketoacidosis
If a diabetic patient has low potassium levels, this may be due to diabetic ketoacidosis. Diabetic ketoacidosis occurs when the body doesn’t make enough insulin to transport glucose to the cells, so it uses fat as fuel instead. The process of breaking down fat releases ketones in the blood, and high levels of ketones can poison the body (American Diabetes Association).
Ketones and glucose are then transferred to the urine, where the kidneys use water to separate blood from glucose and ketones. This process dehydrates the body and reduces potassium levels, quickly worsening diabetic ketoacidosis.
Diabetic ketoacidosis is a serious complication that can be life-threatening and requires immediate attention. Symptoms include shortness of breath, weakness, nausea, extreme thirst and dehydration.
Managing Potassium Levels
First and foremost, it’s important that you meet with your healthcare provider before attempting to treat hypokalemia or hyperkalemia. Both conditions are serious and potentially life-threatening, so it’s essential that you’re informed on your condition and are aware of safe and effective treatment options.
If you have a mild case of low blood potassium, your doctor may advise that you add more potassium-rich foods into your diet. If you have a potassium deficiency and optimizing your diet doesn’t help, your doctor may prescribe a potassium supplement, such as potassium chloride. The effects of potassium supplements are rapid.
If you have a mild case of high blood potassium, your doctor may advise that you eat a low-potassium diet. Severe cases of hyperkalemia are true medical emergencies that require immediate treatment. Treatments may include an IV of calcium, insulin and glucose, diuretics and possible dialysis.
Because the kidneys are responsible for filtering potassium, intaking too much potassium or too little potassium has a direct impact on kidney health and kidney function.
Studies by the Clinical Journal of the American Society of Nephrology have shown that “diets rich in potassium may help protect the heart and kidney health of patients with type 2 diabetes.” These studies also show that higher levels of potassium indicate a lower risk of renal (kidney) dysfunction, chronic kidney disease, and cardiovascular events, such as cardiovascular disease.
Preventing Type 2 Diabetes
While type 1 diabetes is genetic and cannot be prevented, type 2 diabetes can fortunately be prevented.
When you visit one of our experienced endocrinologists in Orlando, we will work with you to create a treatment plan that helps you minimize risk factors to prevent type 2 diabetes!
With the prevalence of diabetes rising, and 1.4 million new cases in America every year, it’s important to take precautions and be proactive in preventing diabetes.
Here are 5 tips to help you manage blood sugar:
- Eat a balanced, low carb diet.
- Reduce portion sizes.
- Increase fiber intake.
- Exercise regularly and take daily walks.
- Drinking lots of water.
Pay attention to your potassium intake, and commit to eating potassium-rich foods every day to prevent hypokalemia.
Our team at UCF Health is here to help you prevent type 2 diabetes and the potential complications that come with it, such as heart disease and kidney disease.
We’ll help you make positive lifestyle changes, so you can prevent type 2 diabetes or manage the symptoms.
Use our online scheduling tool to schedule an appointment with a leading endocrinologist near you! Through our convenient patient portal, you can view lab results, send secure messages to your healthcare provider, view statements and receipts, and manage your prescriptions.
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Sources:
- “Potassium: Health Benefits and Recommended Intake.” Medical News Today, MediLexicon International, https://www.medicalnewstoday.com/articles/287212.
- Momoniat, Tasnim, et al. “ACE Inhibitors and Arbs: Managing Potassium and Renal Function.” Cleveland Clinic Journal of Medicine, Cleveland Clinic Journal of Medicine, 1 Sept. 2019, https://www.ccjm.org/content/86/9/601.
- “Diabetes & DKA (Ketoacidosis).” Diabetes & DKA (Ketoacidosis) | ADA, https://www.diabetes.org/diabetes/dka-ketoacidosis-ketones.