Correlation between Hyperglycemia and Potassium metabolism in Iraqi patients with Type 2 Diabetic Mellitus: A case control study
DOI:
https://doi.org/10.31185/bsj.Vol21.Iss37.1559Keywords:
Serum potassium; Type 2 Diabetes Mellitus;Serum glucose, Pottasium, Ionic metabolismAbstract
Type 2 Diabetes Mellitus (T2DM), a growing metabolic disease that is expected to affect 693 million people by 2045. Hyperglycemia is associated with defect in ionic metabolism, particularly potassium (K+). The current study aimed to explore correlation between serum potassium levels and hyperglycemia, as well as other complication in patients with T2DM . This study included 100 T2DM patients (50 males and 50 females) , aged 40-75 years . A control groups was matched with patient in both age and numbers of participants . Total serum potassium and fasting serum glucose levels were determined using ready-made solutions for the Quantitative determination of potassium ion (IVD). The results revealed significantly lower serum potassium levels in T2DM patients compared with healthy controls (3.493±0.0389 mmol/L vs. 4.268±0.05 mmol/L; P= 0.0001). Female patients showed significantly lower serum potassium levels than controls (4.236±0.069 mmol/L vs. 3.502±0.065 mmol/L; p= 0.0001).Similarly, male patients exhibited significantly lower serum potassium levels compared with controls (3.484±0.043 mmol/L vs. 4.30±0.073 mmol/L; p=0.0001). Additionally , a strong negative correlation was observed between serum glucose levels and potassium concentration in patients, with a regression value of 0.88 and high statistical significance (p<0.001). Conclusion: our finding has explored the a strong negative correlation between elevated glucose levels and decreased in potassium concentration in T2DM patients.
References
1. Cho, N. H., Shaw, J. E., Karuranga, S., Huang, Y., da Rocha Fernandes, J. D., Ohlrogge, A. W., & Malanda, B. (2018). IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice, 138, 271–281. https://doi.org/10.1016/j.diabres.2018.02.023
2. Collaborators, G. 2017 C. C. (2019). The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet Gastroenterology & Hepatology, 4(12), 913–933. https://doi.org/10.1016/S2468-1253(19)30345-0
3. Chatterjee, R., Yeh, H.-C., Shafi, T., Selvin, E., Anderson, C., Pankow, J. S., Miller, E., & Brancati, F. (2010). Serum and dietary potassium and risk of incident type 2 diabetes mellitus: The Atherosclerosis Risk in Communities (ARIC) study. Archives of Internal Medicine, 170(19), 1745–1751. https://doi.org/10.1001/archinternmed.2010.362
4. Rowe, J. W., Tobin, J. D., Rosa, R. M., & Andres, R. (1980). Effect of experimental potassium deficiency on glucose and insulin metabolism. Metabolism, 29(6), 498–502. https://doi.org/10.1016/0026-0495(80)90074-8
5. Association, A. D. (2018). 4. Lifestyle management: standards of medical care in diabetes—2018. Diabetes Care, 41(Supplement_1), S38–S50. https://doi.org/10.2337/dc18-S004
6. Ekmekcioglu, C., Elmadfa, I., Meyer, A. L., & Moeslinger, T. (2016). The role of dietary potassium in hypertension and diabetes. Journal of Physiology and Biochemistry, 72, 93–106. https://doi.org/10.1007/s13105-015-0449-1
7. Yeung, S. M., Oosterwijk, M. M., Poelstra, M., Gant, C. M., Rotmans, J. I., Hoorn, E. J., Vogt, L., Navis, G., Bakker, S. J., de Borst, M. H., & Laverman, G. D. (2022). Low Urinary Potassium Excretion Is Associated with Higher Risk of All-Cause Mortality in Patients with Type 2 Diabetes: Results of the Dutch Diabetes and Lifestyle Cohort Twente (DIALECT). The Journal of Nutrition, 152(12), 2856–2864. https://doi.org/10.1093/jn/nxac215
8. Reshma, S., Sushith, S., Prathima, M. B., Janice, D., Madan, G. R., Gowda, P., Kumar, K. P., Rai, M., & Kalal, B. S. (2020). Serum electrolytes levels in patients with type 2 diabetes mellitus: a cross-sectional study. Diabetes Mellitus, 23(3), 223–228. https://doi.org/10.14341/DM10302
9. Strauss-Kruger, M., Pieters, M., Zyl, T. Van, Jacobs, A., Gafane-Matemane, L., Schutte, A., Louw, R., & Mels, C. (2023). POTASSIUM, URINARY METABOLOMICS, BLOOD PRESSURE AND GLUCOSE METABOLISM: THE AFRICAN-PREDICT STUDY. Journal of Hypertension, 41(Suppl 3), e234. https://doi.org/10.1097/01.hjh.0000941372.82145.c1
10. Surendran, K. T. S., & Sasikala, T. (2020). Sensor Based Non Invasive Dual Monitoring System to Measure Glucose and Potassium Level in Human Body. In Computational Vision and Bio-Inspired Computing: ICCVBIC 2019 (pp. 882–893). Springer. https://doi.org/10.1007/978-3-030-37218-7_94
11. Neuen, B. L., Oshima, M., Agarwal, R., Arnott, C., Cherney, D. Z., Edwards, R., Langkilde, A. M., Mahaffey, K. W., McGuire, D. K., Neal, B., Perkovic, V., Pong, A., Sabatine, M. S., Raz, I., Toyama, T., Wanner, C., Wheeler, D. C., Wiviott, S. D., Zinman, B., & Heerspink, H. J. L. (2022). Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Hyperkalemia in People With Type 2 Diabetes: A Meta-Analysis of Individual Participant Data From Randomized, Controlled Trials. Circulation, 145(19), 1460–1470. https://doi.org/10.1161/CIRCULATIONAHA.121.057736
12. Schroeder, E. B., Adams, J. L., Chonchol, M., Nichols, G. A., O’Connor, P. J., Powers, J. D., Schmittdiel, J. A., Shetterly, S. M., & Steiner, J. F. (2020). Predictors of Hyperkalemia and Hypokalemia in Individuals with Diabetes: a Classification and Regression Tree Analysis. Journal of General Internal Medicine, 35(8), 2321–2328. https://doi.org/10.1007/s11606-020-05799-x
13. Santhosh, V., Gomathi, D. M., Bi, A. K., Suganya, S., Gurulakshmi, G., & N, M. D. (2021). Study of Serum Electrolytes in Type 2 Diabetes Mellitus Individuals in Rural Tertiary Care Hospital in Kancheepuram District. Biomedical and Pharmacology Journal, 14(02), 691–694. https://doi.org/10.13005/bpj/2171
14. Kim, H. W., Lee, D. H., Lee, S. A., & Koh, G. (2015). A relationship between serum potassium concentration and insulin resistance in patients with type 2 diabetes mellitus. International Urology and Nephrology, 47(6), 991–999. https://doi.org/10.1007/s11255-015-1001-5
15. Jiskani, S. A., Khawaja, S. I., & Talpur, R. A. (2018). Disturbances in Serum Electrolytes in Type 2 Diabetes Mellitus. National Journal of Health Sciences, 3(4), 128–131. https://doi.org/10.21089/njhs.34.0128
16. Baqar, S., Michalopoulos, A., Jerums, G., & Ekinci, E. I. (2020). Dietary sodium and potassium intake in people with diabetes: are guidelines being met? Nutrition & Diabetes, 10(1), 23. https://doi.org/10.1038/s41387-020-0126-5
17. Dragila, Ž., Rudić, D., Ćosić, K., & Bačun, T. (2022). Serum glucose, sodium and potassium concentrations in patients with diabetic ketoacidosis. Medicinski Glasnik, 19(2). https://doi.org/10.17392/1471-22
18. Valdivielso, J. M., Carriazo, S., Martin, M., Fernandez-Fernandez, B., Bermudez-López, M., Ortiz, A., Regidor, A., Almirall, J., Ponz, E., Coloma, A., Rubio, B., Ma Auxiliadora, D., Belart Rodríguez, M., Gascón, A., Sanjuan, J. B., Bronsoms Artero, J., Cabezuelo Romero, J. B., Muray Cases, S., Calviño Varela, J., … Virto Ruiz, R. C. (2024). Gender-specific risk factors and outcomes of hyperkalemia in CKD patients: smoking as a driver of hyperkalemia in men. Clinical Kidney Journal, 17(1), sfad212. https://doi.org/10.1093/ckj/sfad212
19. Lee, H., Lee, J., Hwang, S., Kim, S., Chin, H. J., Han, J. S., & Heo, N. J. (2013). Potassium Intake and the Prevalence of Metabolic Syndrome: The Korean National Health and Nutrition Examination Survey 2008–2010. PLoS ONE, 8(1), e55106. https://doi.org/10.1371/journal.pone.0055106
20. Saxena, T., Saxena, M., & Ali, A. O. (2017). Development of diabetes: possible role of potassium. Diabetes & Its Complications, 1, 6.
21. Sitholay, P. A., Agnihotri, M. A., & Ambad, R. S. (2017). Study of renal function and serum electrolyte in type-2 DM. International Journal of Innovative Research in Medical Science (IJIRMS), 2(08). https://doi.org/10.23958/ijirms/vol02-i08/11
22. Jaber, S. Q., Kadhim, A. S., & Al Kateeb, A. I. (2024). Investigating the Expression of miR 203a 3p and Its Role in Inflammatory Response in Severe Preeclampsia of Iraqi women Patients–A Comparative Study. Biomedical and Biotechnology Research Journal (BBRJ), 8(3), 291–296. https://doi.org/10.4103/bbrj.bbrj_210_24.
23. Kadhim, A. S., & Al-Karawi, A. S. (2025). Investigating the multifactorial correlation between obesity and rheumatoid arthritis: a study of immunological and biochemical markers. Obesity Medicine, 53, 100578. https://doi.org/10.1016/j.obmed.2024.100578
24. Wardani, D. A. K., Sugiarto, S., & Cilmiaty, R. (2018). Stress, Nutritional Status and Blood Glucose Levels among Patients with Diabetes Mellitus Type 2. International Journal of Public Health Science (IJPHS), 7(4), 283. https://doi.org/10.11591/ijphs.v7i4.14914
25. Abdulwahid, N. A. (2016). Registry Study for Type 2 Diabetes Mellitus in a Diabetic Center in Saudi Arabia with Comparative Analysis for Controlled Versus Uncontrolled Cases. Journal of Endocrinology and Diabetes, 3(5), 01–06. https://doi.org/10.15226/2374-6890/3/5/00165
26. Sulastri, S., & Harjati, H. (2022). Analysis of Nursing Management Unstable Blood Glucose Levels in Type 2 Diabetes Mellitus Patients. Jurnal Ilmiah Ilmu Keperawatan Indonesia, 12(01), 25–35.https://doi.org/10.33221/jiiki.v12i01.1754.
27. Zhang, Q., Zhao, G., Yang, N., & Zhang, L. (2019). Fasting blood glucose levels in patients with different types of diseases. In Progress in molecular biology and translational science (Vol. 162, pp. 277–292). Elsevier. https://doi.org/10.1016/bs.pmbts.2019.01.004.
28. Lestari, W. S., Fitriana, E., Jumaisa, A., Siregar, S., & Ujiani, S. (2022). Pengendalian Gula Darah pada DM Tipe 2 dengan Pemeriksaan HbA1c di Rumah Sakit. Journal of Telenursing (JOTING), 4(2), 661–667. https://doi.org/10.31539/joting.v4i2.4391.
29. Kadhim, H. I., & Kadhim, A. S. (2024). Exploring the Association between Obesity, Inflammation, and Type II Diabetes: Insights from Body Mass Index Correlation and Immune Response Analysis. Al-Nahrain Journal of Science, 27(3), 50–55. https://doi.org/10.22401/p230yy05.
30. Ratri, D. M. N., Puspitasari, A. D., Nugroho, C. W., Suprapti, B., Suharjono, & Alderman, C. P. (2021). Gender differences in the blood glucose type 2 diabetes patients with combination rapid and long acting insulin therapy. Journal of Basic and Clinical Physiology and Pharmacology, 32(4), 567–570. https://doi.org/10.1515/jbcpp-2020-0463.
31. Hussein, S. E. O., Altoum, A. E. A., Osman, A. L., Higazi, H. M. K. I., Ali, S., & Alfeel, A. H. (2022). Influence of BMI on Serum Adiponectin, Resistine, and FBG among Overweight and Obese Females Diabetic Patient Type2. Open Access Macedonian Journal of Medical Sciences, 10(B), 1218–1221. https://doi.org/10.3889/oamjms.2022.9652.
32. Fadhel, A. A., Al-Tameemi, M., & Alfarhani, B. F. (2018). Biochemical investigation in blood serum of female patients in type-2 diabetes. Journal of Global Pharma Technology, 10(10), 369–373. https://doi.org/10.11591/ijphs.v7i4.14914.
33. Israt, S., Nessa, A., Rahman, H. H., Sharmin, A., Akter, N., Dipa, M. I., Firoz, S., & Saki, S. A. (2021). Correlation between Fasting Serum Glucose and Serum Zinc Level in Patients with Type-2 Diabetes Mellitus. Mymensingh Medical Journal : MMJ, 30(4), 950–953. http://www.ncbi.nlm.nih.gov/pubmed/34605461.
34. Tamimi, W., Tamim, H., Felimban, N., AlMutair, A., Altwaijri, Y., & AlAlwan, I. (2016). Age- and gender-specific reference intervals for serum glucose levels in school children measured by an Advia 1650 chemistry analyzer. Journal of Pediatric Biochemistry, 02(02), 101–108. https://doi.org/10.1055/s-0036-1586401.
35. Mumu, N. S., Nessa, A., Rahman, S., Meherubin, I., Yeasmin, F., Afroz, L., Obi, P. C., Anyanwu, A. C., Nwatu, C. B., Ekwueme, N., Mbaike, A. C., Onyegbule, O. A., Ihim, A. C., Oputa, R. N., Onah, C., Nwako, F. O., Fadhel, A. A., Al-Tameemi, M., & Alfarhani, B. F. (2022). Evaluation of the Status of Glycated Haemoglobin in Male type 2 Diabetic Patients. Mymensingh Medical Journal: MMJ, 31(1), 37–40. http://www.ncbi.nlm.nih.gov/pubmed/34999677.
36. Avnon Ziv, C., Banon, T., Ben Tov, A., Chodick, G., Gabay, L., Auerbach, A., Hirsch, H. J., & Levy Khademi, F. (2023). Glucose levels are not the same for everyone: a real-world big data study evaluating fasting serum glucose levels by sex and age among children. Journal of Pediatric Endocrinology and Metabolism, 36(9), 851–858. https://doi.org/10.1515/jpem-2023-0099.
37. Obi, P., Anyanwu, A., Nwatu, C., Ekwueme, N., Mbaike, A., Onyegbule, O., Ihim, A., Oputa, R., Onah, C., Nwako, F., Nnodim, J., Dioka, C., & Meludu, S. (2016). Pattern of Serum Testosterone and Glycated Haemoglobin among Adult Males with Type 2 Diabetes Mellitus and Erectile Dysfunction Attending a Tertiary Hospital in South Eastern Nigeria. British Journal of Medicine and Medical Research, 18(1), 1–8. https://doi.org/10.9734/BJMMR/2016/28969.
38. Barrett-connor, E. (1980). Factors associated with the distribution of fasting plasma glucose in an adult community. American Journal of Epidemiology, 112(4), 518–523. https://doi.org/10.1093/oxfordjournals.aje.a113021.
39. Kitabchi, A. E., Umpierrez, G. E., Miles, J. M., & Fisher, J. N. (2009). Hyperglycemic crises in adult patients with diabetes. Diabetes Care, 32(7), 1335. https://doi.org/10.2337/dc09-9032.
40. Musso CG, Oreopoulos DG, Oliveri C, et al. Potassium homeostasis in diabetes mellitus. J Nephrol. 2012;25:689–99. https://doi.org/10.11591/ijphs.v7i4.14914.
41. Friedrich S, Wanner C, Heering P. Electrolyte disturbances in diabetes mellitus. N Engl J Med. 2018;379:163–74. https://doi.org/10.11591/ijphs.v7i4.14914.
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Copyright (c) 2026 م.م.ليث عمار شياد جامعة واسط/كلية التربية الاساسية، م.م.وسام حسيب شاكر جامعة واسط/كلية التربية الاساسية، أ.د. ظافر حسن غالي كلية التربية للعلوم الصرفة، أ.م.د.علي سعد البديري جامعة واسط/كلية التربية الاساسية
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