Hypokalemia, glucose intolerance, and hyperinsulinemia during diuretic therapy.
نویسندگان
چکیده
Hypokalemia and glucose intolerance may result from diuretic therapy. Increases in plasma insulin and glucose levels have been observed in thiazide-treated hypertensive patients and have been attributed to a diminished insulin sensitivity induced by diuretic therapy. To investigate the effects of hypokalemia on glucose tolerance and insulin secretion, we studied 21 essential and nine diabetic hypertensive patients after 4 weeks of placebo and after 4 weeks of chlorthalidone therapy (25 mg/day). Plasma glucose and insulin levels were measured for a 3-hour period after a 75-g glucose oral dose. Hypokalemia developed in seven of the essential hypertensive patients (HK group), whereas only one diabetic patient had decreased plasma potassium levels to below 3.5 meq/l. The results obtained in the HK group after chlorthalidone showed that plasma glucose and insulin values increased after the oral glucose load to levels significantly higher than those observed after placebo. In contrast, the patient who remained normokalemic after chlorthalidone did not show any change in plasma insulin and glucose levels during glucose tolerance testing. These results show that diuretic therapy may induce hyperglycemia and hyperinsulinemia and suggest that potassium depletion is involved in the increase in insulin resistance that has been demonstrated during thiazide therapy.
منابع مشابه
Thiazide diuretics, potassium, and the development of diabetes: a quantitative review.
National guidelines and a recent clinical trial have supported the use of thiazide diuretics as the preferred initial pharmacological treatment for hypertension. However, evidence from this and other clinical trials have also found an increased incidence of new onset diabetes among those patients receiving thiazide diuretics. The mechanisms responsible for the increased incidence of diabetes wi...
متن کاملHypertension, hypokalemia, and thiazide-induced diabetes: a 3-way connection.
Reduction in the dose of diuretics to treat essential hypertension occurred with the recognition that higher doses of thiazides cause hypokalemia, glucose intolerance, and hyperuricemia but little additional reduction in blood pressure.1 Subsequently, large randomized, controlled trials have demonstrated a higher incidence of diabetes mellitus with thiazide diuretics compared with other antihyp...
متن کاملAssociation of early-onset coronary heart disease in South Asian men with glucose intolerance and hyperinsulinemia.
BACKGROUND Rates of coronary heart disease are higher in South Asians (Indians, Pakistanis, and Bangladeshis) settled overseas than in other ethnic groups. We tested the hypothesis that this excess risk results from metabolic disturbances associated with insulin resistance. METHODS AND RESULTS There were 1,421 South Asian men and 1,515 European men aged 40-69 years in London examined in the S...
متن کاملThe relationship between pregnancy weight gain and impaired glucose tolerance test
Impaired glucose tolerance has several adverse effects on growing fetus. In this study we evaluated the effect of excessive weight gain during pregnancy on the risk of glucose intolerance in pregnant women. A case-control study was conducted through which the glucose tolerance status after 100 gram oral glucose intake was compared between 60 pregnant women with maximum 10 weeks of gestation and...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Hypertension
دوره 19 2 Suppl شماره
صفحات -
تاریخ انتشار 1992