The Power of Potassium :: Diabetes Self-Management

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Apr 16, 2007

The Power of Potassium

Amy Campbell

We’ve talked about several different minerals in past blog entries. Potassium is the mineral of choice for this week’s post for several reasons, and it’s a mineral that people with kidney problems should be sure to pay close attention to.

First, let's explore what potassium does in the body. This mineral is often referred to as an "electrolyte." Electrolytes are electrically charged particles, called ions, which our cells use to maintain voltage across our cell membranes and carry electrical impulses, such as nerve impulses, to other cells. (Bet you didn't think you had all this electrical activity in your body, did you?) Some of the main electrolytes in our bodies, besides potassium, are sodium, chloride, calcium, and magnesium. Your kidneys help regulate the amount of electrolytes in the body.

Potassium's job is to help nerve conduction, help regulate your heartbeat, and help your muscles contract. It also works to maintain proper fluid balance between your cells and body fluids. The body is a fine-tuned machine in that, as long as it's healthy and functioning properly, things will work as they should. This means that, as long as your kidneys are working up to par, they'll regulate the amount of potassium that your body needs. However, people with diabetes who have kidney disease need to be especially careful of their potassium intake, as levels can get too high in the body when the kidneys don't work as they should. Too much potassium is just as dangerous as too little.

Your physician can measure the amount of potassium in your blood with a simple blood test. A normal, or "safe" level of potassium is between 3.7 and 5.2 milliequivalents per liter (mEq/L). Levels below or above this range are a cause for concern.

Low potassium levels (hypokalemia) may be due to something as relatively simple as dehydration from excessive sweating, vomiting, or diarrhea, or to something more serious such as an adrenal gland problem, cystic fibrosis, or severe burns, for example. Low levels can also result from taking diuretics or from malnutrition.

High potassium levels (hyperkalemia) often result from kidney damage. Kidney damage is usually due to poorly controlled diabetes, and is considered a major complication of diabetes (it's often referred to as diabetic kidney disease, or diabetic nephropathy). High potassium can also occur if someone has had diabetic ketoacidosis (DKA), a serious metabolic condition more commonly seen in people with Type 1 diabetes. Heart attack, injuries, infections, overuse of potassium supplements, and use of ACE inhibitor drugs may also lead to high potassium levels. Too much potassium, by the way, can lead to weakness, paralysis, irregular heartbeat, or even a heart attack.

If you have diabetic kidney disease and your potassium levels are high (above 5.2), your health-care provider will likely recommend you cut down on how much potassium you get in your diet. Foods high in potassium include bananas, cantaloupe, potatoes, tomatoes, and legumes, for example. It's not that you can no longer eat these foods, but you'll need to watch your portions of them and not eat them too often. In addition, you shouldn't use salt substitutes or take potassium supplements unless otherwise advised by your health-care provider. Meeting with a dietitian is extremely helpful, as he or she can help you develop a low-potassium meal plan and provide you with helpful tips to make things easier. If your potassium level is very high (over 6.0), your physician may recommend a medicine, such as sodium polystyrene sulfonate (brand names Kayexalate and Kionex), which helps remove potassium from the body. Diuretics can also help lower potassium levels.

Talk to your health-care provider if you have any concerns about your blood potassium level or the health of your kidneys in general. Do the best you can to keep your HbA1c level below 7%, and be sure to get your microalbumin level (a test for urine protein that detects kidney damage) checked every year. Diabetic kidney problems can be prevented or slowed if caught early on.

POST A COMMENT E-MAIL A FRIEND

Hello Amy, I just had to write and thank you for all the unbiased useful information you guys shower me with. Keep up the good work and thank you so much.

Posted by: Timtam | Apr 25, 2007 06:04 PM

I am wondering if someone can let me know what happens when you are told that your potassium is way high, and you already have kidney failure and diabetes, and high cholestrol and high blood pressure?

Posted by: scared | Sep 06, 2007 02:01 PM

Dear scared,

I can certainly understand why you might be feeling scared. Having kidney failure and high blood pressure, on top of having diabetes, is bound to be overwhelming and confusing. The first thing I'd recommend is to talk to your doctor as soon as possible about your high potassium level. This needs to be addressed sooner rather than later. Also, if you're not already working with one, ask your doctor for a referral to a kidney doctor, or nephrologist. And at the same time, see if you can get an appointment with a renal dietitian. You need a team who understands diabetes and kidney disease. They can help you with meal planning and medication management specifically geared towards your kidney health. Check out the National Kidney Foundation's website, too at www.kidney.org for more help and support. There may even be a local affiliate in your area.

Posted by: acampbell | Sep 07, 2007 10:40 AM

Hello, I am 28 years old and I am 330 pounds. I have a really hard time sticking to a diet and exercise, I just seem tired all the time, all I want to do is sleep or just sit down. They say my thyroid is fine. You have any suggestions?

Posted by: Tired of being Fat | Sep 07, 2007 11:01 AM

WHAT ARE THE PRECAUTIONS WHICH WE SHOULD TAKE IF WE HAVE DIABETES AND KIDNEY FAILURE. THE AGE BEING 53 YEARS? WHICH THINGS SHOULD TAKE AND NOT TO TAKE? AND ANY OTHER IMPORTANT INFORMATION WHICH U CAN GIVE ME.

Posted by: taruna | Jun 14, 2008 05:11 AM

Hi taruna,
This is really a question for your primary care provider. The answer depends on so many factors, such as the extent of your kidney failure, other health issues you may have, and other medications that you take. It's beyond my scope to adequately answer you. Many medications, including diuretics and diabetes pills can affect your kidneys, so you need to talk with your physician about what's safe for you to take. Also, consider talking with your pharmacist, too, as they truly are medication experts.

Posted by: acampbell | Jun 16, 2008 04:03 PM

i am a diabetic whom works outside. the heat gets to me. i sweat a lot. i cramp every day as long as the temp is over 60 degrees. i have spoke to my doctor and he can give me something but doesnt really want to go there because my kidneys have no problem. my wife bought me potassium pills to take 1 a day. but i am wondering how much potassium is in 1 banana and if that is the way i should go.

thanks if you answer me back
Bud

Posted by: bfox | Jul 09, 2008 08:42 PM

Hi Bud,

Did your physician tell you to increase your potassium intake? Sometimes cramps can be due to deficiencies of other nutrients, too, such as magnesium. The recommended intake for potassium is at least 3500 mg per day (assuming your kidneys are in good health!). A banana has 422 mg of potassium, while a sweet potato has almost 700 mg. Check out this listing for more information on food sources. It's probably best to avoid taking potassium pills unless your physician prescribes them, since you don't want to end up taking too much potassium. Aim to get your needs met through food sources as much as possible.

Posted by: acampbell | Jul 10, 2008 02:18 PM

My mom passed away from too high potassium - I suggest any one that has diabetes, heart problems or any signs of diarehea be checked.

bf

Posted by: bf | Jul 14, 2008 08:48 PM

Hi bf,

Do you know what her level was and for how long? I've just been dignosed with High Postassium and mine is 5.6

Posted by: 4justin5 | Jul 15, 2008 05:00 PM

3500mg of potassium a day is not an easy number to hit. How common is the "too high potassium" level reaction for people who are not taking supplementation? It seems if a person is attempting to consume potassium through diet alone most people are nowhere near the 3500mg mark. Are people with diabetes perhaps more responsive to postassium intake and therefore should be taking in less than a person without diabetes? I know it all comes down to the proper testing, but I'm a personal trainer with several diabetic clients that all seem to be being told something very different from their physicians. If its been confirmed that a person is taking in proper amounts of H20, Magnesium, & Calcium, but experiences muscle cramping during physical activity can the next logical concern be proper potassium levels? Just looking for some insight in on the topic.
Thank you

Posted by: Paige Christine | Aug 04, 2008 10:33 AM

Hi Paige,
Thanks for your comments. While we know not everyone always eats a "balanced" diet every day, it definitely is possible to meet the daily potassium requirements through food sources, especially if you're consuming several servings of fruits and vegetables, whole grains and milk/yogurt each day. Some people may need more potassium if they have certain gastrointestinal conditions, if their blood glucose levels have been running high for a while, or if they take certain types of diuretics. Others may need less potassium if they have kidney disease. So, the need for potassium can vary from person to person, which is why people do need to check with their healthcare provider. Unless kidney disease is present, most people will not get too much potassium from food sources, but they may if they take supplements. It's logical to assume cramping can occur due to lack of potassium, but then again, cramping might be due to decreased circulation and/or peripheral arterial disease, as well, particularly if the cramping occurs consistently.

Posted by: acampbell | Aug 04, 2008 02:05 PM

I have Diabetes and eat bananas every day.Is there any danger of suffering a serious reaction because I eat them so much?
Thank you.

Posted by: thinthin | Aug 18, 2008 09:29 PM

Hi thinthin,
There's no problem with eating bananas every day, assuming your kidneys are in good health and that you aren't allergic to them. You'd have to eat about 8 bananas a day to reach the daily goal for potassium. The main thing is to make sure that the bananas fit into your meal plan or into your carbohydrate goals for your meals and snacks. If you're constantly snacking on bananas, it's likely to affect your blood glucose levels. One medium, 7-inch banana contains close to 30 grams of carbohydrate, so this needs to be considered as part of your carb allotment for the day.

Posted by: acampbell | Aug 19, 2008 07:44 AM

This is the first time I've visited your web site which I think is excellent. I also have diabetes and spend a lot of time on the Internet reading different articles. One of the web sites I visit frequently is the National Institutes of Health web site www.nhlbi.nih.gov which has a list of foods high in potassium. In it I discovered that 1 ounce of avocado contains 180 mg of potassium. This was a blessing for me because I was concerned about the carbs in bananas (which I enjoy very much but only when my BG reading is low). Perhaps thinthin should switch from bananas to avocados to get his potassium. Another web site I discovered was the Linus Pauling Institute at Oregon State University. On their page 'Micronutrient Requirements for Older Adults (>50 years)' they recommend 4,700 mg/day of potassium. I weighed the avocados I bought and they average 6 ounces which gives me about 1,080 mg of potassium. I can make up the rest with a combination of potassium-rich foods and supplements.

Keep up the good work!

Posted by: John | Sep 01, 2008 02:18 AM

Hi John,
I'm glad to hear that you like the website! Thanks for sharing the info about avocados. Just a word of caution, though - while they are a great source of potassium, a whole (6 ounce)avocado also contains 320 calories, 16 grams of carb and about 30 grams of fat!

Posted by: acampell | Sep 02, 2008 02:50 PM

Hello,

Good article. However, I read that potassium levels can also be affected by more insulin levels as insulin causes transcellular shift of potassium from ECF to ICF as indictedon Insulin-wikipedia:-
[Insulin]"Increased potassium uptake - forces cells to absorb serum potassium; lack of insulin inhibits absorption. Thus lowers potassium levels in blood.
Arterial muscle tone - forces arterial wall muscle to relax, increasing blood flow, especially in micro arteries; lack of insulin reduces flow by allowing these muscles to contract."

Under above consideration, can you also tell about impact of insulin, insulin resistance & hyperglycemia on potassium levels? Regards. Kumar

Posted by: kumar | Sep 06, 2008 02:55 AM

Hi Kumar,
Thanks for the feedback. Insulin does a lot more than just move glucose into cells; it also helps move potassium, magnesium and phosphate ions, as well. Insulin and potassium have a feedback mechanism, so that if, for example, blood levels of potassium get too high, insulin is released from the beta cells to help lower the levels. There is some indication that people who have metabolic syndrome or type 2 diabetes have a low level of potassium in their cells. Other research shows that a diet rich in high-potassium foods helped reduced the risk of type 2 diabetes. And yet another study showed that people with adrenal gland disorder were more likely to have lower potassium levels and more insulin resistance than in those without the disorder. The speculation is that potassium deficiency may play a role in the development of metabolic syndrome, a precursor to type 2 diabetes.

Posted by: acampbell | Sep 09, 2008 10:58 AM

Thank you for all of your information on potassium and how it works with the body. I have been on diuretics for the past 7 years and understand I need to have either a banana a day or drink orange juice to maintain a healthy level of potassium. But since taking diuretics I have had leg cramps, muscle spasms, sciatic pain etc. I had started taking calcium and magnesium supplements that helped for a while, but after reading many publications I believe my potassium level is low, so I took just one potassium supplement and can say that the muscle cramps and spasms were not experienced today. I will be seeing my doctor in about a month and it is procedure to have labs done before the visit. I did ask my Dr. to add a potassium reading with the next labs, so I will know for sure if my levels are low until then. I feel really good today and don't want to harm myself. would taking one potassium supplement a week be harmful?

Posted by: lmatt | Sep 11, 2008 04:43 PM

Hi lmatt,

Generally, it's not a good idea to take potassium supplements without first consulting with your physician. However, taking one potassium tablet per week is probably okay. Check to see how much potassium is in one tablet, and also think about how much potassium you might be getting in your food (see an earlier posting with a link to food sources)to make sure you're not taking in too much. Remember that the goal is 3500 mg of potassium per day. And when you see your doctor next month, let him know that you're taking potassium. Stop taking the supplement and call your doctor right away if you have any side effects, such as fatigue, weakness, irregular heartbeat or shortness of breath.

Posted by: acampbell | Sep 12, 2008 01:07 PM

Thank you for your response. I did review your list of potassium rich foods and I can honestly say that the only food product that I may have often would be Tomato juice/V8 juice, and that may not be daily. I can see that I am probably getting about 1000 mg's a day. I am not a milk drinker and the suppliment is only 565 mg. I must testify that by taking the potassium yesterday I did not encounter any muscle spasms/cramps or muscle fatigue. I will be sure to tell my doctor about taking the suppliment. I will also review the food items and try to work in potassium rich foods to my diet. I will limit myself to one potassium suppliment a week and get my labs done soon.

Posted by: Lmatt | Sep 12, 2008 02:58 PM

wow i love this web site!it was helpful. thank you

Posted by: maya | Sep 17, 2008 04:57 PM

I take teveten for high blood pressure and it says not to take potassium supplements. Can you please tell me how much potassium is too much for me, ie can I have the soups and bananas and panadol?

Posted by: Lidija | Oct 07, 2008 06:36 PM

Hi Lidija,

Teveten is a type of medication, called an angiotensin II receptor blocker, or ARB, for short. It helps to lower blood pressure and may help slow the progression of kidney disease, as well. If you take this medication, you shouldn't take over the counter potassium pills, or supplements, or use salt substitutes that contain potassium. However, you can still eat foods that contain potassium, including bananas and potatoes as long as your kidneys are healthy. If you have kidney problems, you may need to limit your potassium intake, and you should ask your doctor about how much potassium you can have.

Posted by: acampbell | Oct 08, 2008 03:06 PM

My husband had a scare last night.

He is not on any medicine for diabetes, but from time to time his blood sugar will elevate.

Last night, he came in, was very thirsty and got a drink out of the frig (Mountain Dew/total sugar) and went outside and drank it.

Almost immediately, he lost his balance, had a headache and was sick to his stomach. His blood pressure was very high. He took a nitro pill and the blood pressure went down. He does have problems with his blood pressure every now and then and does take medicine for that.

I tried to get him to go to the hospital, he's stubborn and he would not go.

This morning his balance is fine, his blood pressure is ok, but still alittle high, but his blood sugar was 348.

I am scared as I feel he could have a stoke at any time.

How do you lower blood sugar other than using medicine?

Any help would be appreciated.

Thanks,
Brenda

Posted by: Brenda | Oct 14, 2008 08:18 AM

Hi Brenda,
I can certainly understand your concern. It sounds like there are two situations for which he should seek medical attention sooner rather than later: his blood pressure and his diabetes. Regarding his diabetes, it's very likely that he will need a medication, given the blood sugar of 348. However, it's important to look at his overall diabetes control and that means finding out what his hemoglobin A1C is. The A1C goal for most people with diabetes is less than 7%. Weight loss, a healthy eating plan and physical activity can all help lower blood glucose, but there often comes a time when medication is needed, as the pancreas eventually stops making sufficient insulin. Let your husband know that you're concerned and perhaps show him some reading material on diabetes and A1C. Also encourage him to make an appointment with his provider to discuss both his blood pressure and diabetes control.

Posted by: acampbell | Oct 14, 2008 01:46 PM

Just checked this web site great information.I'd love to get some answers to my problems if I may.

here goes, How much pottasium, phophorus, can I consume in a day?

Since going on a renal diet I've gained a lot of weight, at present 220 I'm 5'2" I 'm not doing it any more since 3 days now.

My fasting sugars used to be between 4-6 and now are 11.5, creatinine is 203, eFGR is 22, Urate is 426, Hemoglobin A1C is 0.005, I a mess I'm trying to control my blood sugars with herbs and spices
I'm not on any meds since the last 3 days I go for another blood work in 3 weeks, may I keep you posted The herbs and spices I'm having are fenugreek, cinnamon, Bitter melon.
I sure appreciate your web site and thank you for reading my e=mail I'm 74 years old.
getten

Posted by: getten | Nov 11, 2008 02:52 PM

Hi getten,
I'm glad to hear that you find this Web site helpful! Unfortunately, I really can't give you specific advice on your diet - only your physician and dietitian can. However, it does appear that your blood glucose levels are running a little on the high side. I'm not sure I understand what your A1C level is, though. Also, your kidney function tests are not where they should be, either. Please reconsider taking your diabetes medications. Herbs and spices aren't proven treatments for diabetes and it's difficult to determine just how much of them you'd really need for glucose control. Also, I'd strongly suggest you see a dietitian for a renal diet that will help you reach a healthy weight. Your physician should be able to give you a referral. I'd be happy to hear how you're doing after your appointment in three weeks.

Posted by: acampbell | Nov 13, 2008 09:26 AM

Thanks Amy, for your prompt reply, I'll sure keep in touch.

getten

Posted by: getten | Nov 13, 2008 02:19 PM

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