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Let's talk about potassium and diabetes.
Specifically, we’re going to talk about a special situation with diabetes type 1 and potassium. There’s a rare situation in which potassium levels in your blood can actually go too high with diabetes type 1.
We’re going to explain how that works and what to look out for.
In this article: -
- How Insulin and Potassium Work Together
- Many Conditions Create Insulin Problems
- Other Common Potassium Problems
Understanding How Insulin and Potassium Work Together
Insulin controls potassium in the cell and drives potassium into the cell where it should be stored So if you have more insulin, there will be more potassium going into the cell. In fact, 98% of all your potassium in your body is inside the cell, not outside the cell or even in your blood. You only have 2% of your potassium in your blood.
And it’s there because insulin helps put it there.
Many Conditions Create Insulin (and Potassium) Problems
If you have a problem with your insulin, then, you’re going to also have a problem with potassium.
This can happen first if you have insulin resistance. Now, a lot of people today do have this condition (and it's not always related directly to diabetes). See, insulin appears in the body primarily as a response to sugar or glucose. You eat glucose, your blood sugar goes up, and insulin shows up to get it back down and normalize your glucose levels. Today, though, people have way too much sugar. They’re eating it all the time, so their body is constantly releasing too much insulin to try to keep up.
Eventually, the cells start blocking that insulin. That’s when you develop insulin resistance and type 2 diabetes. In fact, most people with type 2 diabetes are insulin resistant, and that's part of why type 2 diabetes causes blood sugar to go out of control so frequently. The insulin can't help control your diabetes as it should.
It can also prevent potassium from getting into your cells because the insulin is blocked.
Type 1 Diabetes
In diabetes type 1 (which is very different from type 2 diabetes) you kind of have the opposite problem, though it has the same outcome of too little potassium in your cells.
See, with this kind of diabetes, your body doesn’t produce enough insulin and you have to inject yourself. That means that you can’t drive the potassium in the cell anymore (like with insulin resistance).
Inside the cell, then, you’re going to have very low amounts of intracellular potassium. But, if you consume potassium it has to go somewhere. If it can’t go into the cell, it’s going to stay loaded up in the blood.
This is called hyperkalemia. It’s rare - only 1% of people and very few diabetic patients have it - but it can happen, especially if you’re consuming large quantities of potassium in your type 1 and your body is not able to drive it in the cell.
This can cause major symptoms and big-picture health concerns, including:
- Muscle pain
- Muscle weakness
That, of course, is on top of your other type 1 diabetes symptoms, which include:
- Increased thirst
- Frequent urination and changes in urine
- Extreme hunger and metabolic changes
- Unintended weight loss
- Fatigue and weakness
- Mood changes
How to Know if You Have Hyperkalemia
If you have type 1 diabetes, I highly recommend that you get an intracellular potassium test. It checks all the minerals, and I think it’s very important because if you go to the doctor and you get a general blood test and it’s high, that doesn’t necessarily mean your potassium levels are high in the cell. It means they're high in the blood. You want to check how it’s doing in your cells.
That said, keep in mind that it’s highly unlikely that you’re going to get this condition from consuming potassium-rich vegetables and dietary potassium, even if you have seven to ten cups of vegetables a day. Instead, it usually happens if you have a crazy-high potassium intake - between 5000 -10000 mg - in supplement form.
Other Common Potassium Problems
Remember, though, that this isn’t a problem that most people have to deal with. This only applies to people with type 1 diabetes who consume a lot of potassium. For most people, the concern is actually potassium deficiency (both in the cell and in the blood).
Potassium deficiency is actually pretty common. See, we have to consume a lot of potassium (about 4700 milligrams) each day to reach our daily requirements. Most people don’t get that much. Instead, they usually get low potassium and really high sodium. In fact, on average, people consume four times as much sodium as they do potassium. This is the wrong sodium ratio - it should be 4:1 in favor of potassium - and it can exacerbate deficiencies.
Even if this isn't the problem and you do get enough potassium (and not too much sodium) some people still don’t have good levels because they have the following risk factors:
- Vomit: Vomiting regularly - whether it’s because you’re suffering from bulimia or simply because you’re sick - can deplete potassium levels in the body.
- Are in ketosis: Ketosis is the state of fat-burning when you’re eating more fat, no carbs, and you can become deficient in potassium from that, too. That’s why I always modify the ketosis diet and make sure that we have enough greens and vegetables to balance things out and prevent this problem.
- Take diuretics: Say you’re on a blood pressure medication. Well, you’re going to deplete the potassium and keep the blood pressure there. That’s actually one of the side effects of many blood pressure medications. So you better make sure that your diuretic is not pulling out potassium without you putting it back in.
- Have high cortisol: Cortisol is the stress hormone. Stress can also deplete potassium. In fact, I’ve had people do advanced testing on their potassium levels - they are eating huge amounts of potassium, but because they’re under tremendous amounts of stress, their potassium stays low. That’s because, when the adrenals are that depleted, it’s almost like you have a hole in the bucket and the potassium goes right through. So your levels will never be where they’re supposed to be if you’re amazingly stressed.
- Drink too much water: When you drink too much water, you create a condition called hyponatremia, which is a dilution of all your electrolytes. Then your heart starts going out of balance and you can have a heart attack by drinking too much water. You only want to drink water when you’re thirsty so you don’t flush out all your electrolytes.
This is a pretty common deficiency, and it can cause lots of problems like:
- High blood pressure: When you’re low in potassium, blood pressure will increase. Why? Because potassium is a physiological relaxer. It’s a tranquilizer. It calms things down.
- Muscle cramps: Potassium is an electrolyte, meaning it helps control electricity and muscle function in the body. If it’s low, you’re more likely to experience cramps and charlie horses.
- Sugar cravings: Potassium helps you store glucose, and it’ll actually help you get rid of sugar cravings because the storage of glucose needs potassium.
- Constipation: Potassium helps regulate digestion and keep things flowing.
- High insulin: There’s a relationship between glucose, blood sugar, diabetes, and potassium. In fact, when you have enough potassium, the need for insulin goes down - so I always recommend potassium for diabetic patients.
- Muscle weakness: You can have this inexplicable muscle weakness and not know why. That’s because electrolytes are needed to help the muscles contract.
- Abnormal heartbeat: That’s also why you can have an abnormal heartbeat. The heart is a muscle. These abnormal heartbeats - for example, atrial fibrillation and arrhythmias - are a combination of deficiency in potassium and/or magnesium.
- Anxiety and insomnia: Again, potassium is something to calm you down. So if you’re doing, for example, a diet that doesn’t involve a lot of potassium, you can start manifesting a lot of these symptoms.
- Kidney troubles: Potassium is necessary for proper kidney function. If your levels are low, it could make your kidneys less efficient and harm your overall renal function.
Overall, I just wanted to bring your awareness up and help you understand that, if you’re a diabetic type 1, your potassium could potentially rise and you could have a problem - especially if you’re trying to increase it. You should also know that the function of insulin is to drive potassium into the cell. But again, in this situation, since you don’t have enough it’s not going into the cell, creating a situation.
Again, I think the most important thing to do - if you have any of these symptoms and if you’re concerned about it - is to get a blood test or a urine test to see if your serum potassium is high. Also, get an intracellular test to measure how much potassium and other minerals are inside your cells. This will give you more data and help you understand what’s going on.
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