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Suffering from diabetes and hypokalemia. Which should be treated first?

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Internal Medicine Specialist
Practicing since : 2001
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If a patient has both diabetes (eg. Blood sugar 450 mg/dl) and hypokalemia (eg. 2.5 mmol/l), which one should be corrected first, hypokalemia or diabetes?
Posted Thu, 11 Apr 2013 in Diabetes
Answered by Dr. Ram Choudhary 1 hour later
Welcome to healthcare magic!
The condition you have put up is very XXXXXXX and should be handled only in an well equipped healthcare set-up.
The sugar level is sky high and the potassium level is bottom low.
The low potassium can cause lethal cardiac arrhythmias and can kill the patient while uncontrolled sugar is detrimental to health because it siphons away the body resources and makes one susceptible to infections and diabetic ketoacidoses.
Let us come to your query- The potassium should be corrected first and a level of 4.0 Meq should be achieved before the control of hyperglycemia is tried.
When we try to correct glucose with insulin it tend to decrease potassiun levels, which is already dangerously low in this case. So replace the K+ and achieve 4.0 level then try correcting glucose. Glucose and K+ levels must be done every 2nd hourly till good ranges are restored.
I hope you would get benefited with my advise.
Wish you a good health.
Above answer was peer-reviewed by
Follow-up: Suffering from diabetes and hypokalemia. Which should be treated first? 2 days later
Thanks for the answer.
Answered by Dr. Ram Choudhary 6 hours later
Welcome back to healthcare Magic!
I hope the information has been upto your expectation, I would like to add that the levels of potassium you have mentioned are drastically low and should be corrected as soon as possible so please be proactive on that front.
Wish you a great health and thank you for the feedback.
Take Care!
Above answer was peer-reviewed by
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