Low Levels of Potassium Linked to Increased Diabetes Risk

By: Byron J. Richards, Board Certified Clinical Nutritionist
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Three recent studies show that even low-normal potassium scores on a blood test are associated with significant increased risk for type 2 diabetes. This risk applies to anyone and is especially elevated in African Americans who consume less dietary potassium and in individuals taking diuretic medication for blood pressure control.

The first study1 involves 12,209 participants followed for 9 years. On a lab test the number range for healthy is 3.5 – 5.5.  The researchers compared those with scores lower than 4, scores 4 – 4.5, and scores 4.5 – 5 to those with scores in the high end of the normal range (5 – 5.5). They found a 64% increased risk in the 4 and below group as well as in the 4 – 4.5 group. Surprisingly, they even found a 39% increased risk in people with scores in the 4.5 – 5 group. 

The second study2 was a subset of data by researchers in the first study, comparing African Americans to whites.  The results for whites was similar to the above, whereas African Americans with scores of 4 or less had a 126% increased risk, a score of 4 – 4.5 was a 97% increased risk, and a score of 4.5 – 5 was a 85% increased risk. The data shows that African Americans are especially susceptible to a lack of potassium contributing to type 2 diabetes.

The third study3 followed 4,409 Japanese men for 4 years. Those with potassium below 4 had a 57% increased risk. For each .5 lower score in potassium at the start of the study was associated with a 45% increased risk of developing type 2 diabetes over the four year study period.

It is believed that potassium influences the release of insulin from the pancreas so it could be said that low potassium contributes to pancreatic stress and future insulin resistance leading to type 2 diabetes.The relationship of adiponectin to potassium is not yet understood, other than it is now known that adiponectin utilizes potassium ions in your brain to release metabolic signals. African Americans are known to have lower adiponectin at birth – a potential weak spot that appears to be synergistically aggravated by low potassium intake.

The reason I am making a point about these lab test numbers is that they relate to potassium scores even in the normal range. Scores in the middle of normal are not even adequate.

Potassium levels in your blood are low in general, as most of your potassium is in your cells. Thus, even slight lack of potassium in your blood reflects a larger lack of potassium in your cells and apparently impaired glucose metabolism function.

Signs of potassium weakness include muscle fatigue and sensitivity to heat – a problem that is more noticeable in hot and humid weather. Individuals who sweat a lot from exercise could also lower their potassium levels without realizing it.  A lack of potassium also causes a person to be more sensitive to salt. Ironically, low potassium may be causing salt-sensitive high blood pressure for which a diuretic is typically given. This will invariably deplete potassium and induce insulin resistance and the risk for type 2 diabetes. This is one way that blood pressure medication causes weight gain and worsens health.

Fruits, vegetables, and red meat are high sources of potassium, especially bananas and avocados. Potassium supplements along with potassium from food should be used to get potassium levels to the current high-normal range.  From the point of view of type 2 diabetes risk there should actually be a new lab range for potassium, with normal being 5 – 5.5.

Referenced Studies:
  1. ^ Potassium and the Risk for Type 2 Diabetes - Gemeral Population  Arch Intern Med.  Chatterjee R, Yeh HC, Shafi T, Selvin E, Anderson C, Pankow JS, Miller E, Brancati F.
  2. ^ Potassium and the Risk for Type 2 Diabetes - African-American Study  American Journal of Clinical Nutrition  Ranee Chatterjee, Hsin-Chieh Yeh, Tariq Shafi, Cheryl Anderson, James S Pankow, Edgar R Miller, David Levine, Elizabeth Selvin, and Frederick L Brancati.
  3. ^ Potassium and the Risk for Type 2 Diabetes - Japanese Men  Diabetologia.   Heianza Y, Hara S, Arase Y, Saito K, Totsuka K, Tsuji H, Kodama S, Hsieh SD, Yamada N, Kosaka K, Sone H.

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