Interactive diabetes case 15: A 74-year-old patient with type 2 diabetes and recurrent hyperkalemia – A1

ANSWER — Incorrect.

You are correct to suspect the diagnosis of hyperglycemia-induced hyperkalemia in the setting of longstanding diabetes and impaired kidney function.

A low potassium diet is a necessary but not sufficient part of the treatment of this disorder. If it works at all, it will be effective only over a period of days to weeks. Although the patient is tolerating the potassium level of 5.9 to 6.0 mEq/L at this time, with no evidence of cardiac toxicity, it is essential to reduce this level, and in so doing to prevent it from rising still higher.

The immediate issue is to reduce the serum potassium level promptly. If the diagnosis is correct, then the potassium level should fall with administration of insulin and correction of the hyperglycemia.

Return to the beginning to try again. (See "Interactive diabetes case 15: A 74-year-old patient with type 2 diabetes and recurrent hyperkalemia".)