Hyperkalemia a Therapeutic Callenge for Physicians Treating Patients of Type 1 and Type 2 Diabetes Mellitus in Saudi Arabia

The objective of this study is to determine the level of hyperkalemia in Saudi patients of type 1 and type 2 diabetes mellitus. In the present study, 362 male and female known diabetic patients of type 1 and type 2 and 158 non diabetic control subjects visiting Al Iman and Prince Salman hospitals of Riyadh were studied from November 2004 to July 2006. 12.6% type 1 and 18.5% of type2 diabetics in our study had some sort of impaired renal functions, but none of them had shown signs of acute renal failure. Only a small percentage of 5% patients in type 2 diabetes group 3 were on ACE inhibitors. The diabetics were subdivided on the basis of their fasting plasma glucose levels (FPG) in three groups, group 1( 7.1 -10.0 ) group2 (10.1 -20.0) and group3 ( >20.0) mmol / L and their serum potassium levels were estimated. Hypekalemia was not detected in the group1 diabetics of type1and females of type2. The group 2 diabetics of type 1 and type 2 showed serum potassium levels of 5.9+1.1 and 7.2 + 1.4 mmol /L ( P <0.001). The serum potassium levels among the group 3 diabetics with a FPG of > 20 mmol /L were 6.8 + 1.2 ( r = 0.56) and 8.1+ 1.7 mmol /L ( r =0.68 ) P< 0.05. It was observed that there is a strong association between hyperglycemia and hyperkalemia , even in the absence of dialysis or RAAS therapy, in Saudi diabetics. The elderly uncontrolled diabetics are at a higher risk of hyperkalemia. Hyperkalemia in uncontrolled diabetics can lead to kidney and liver damage and cardiac arrest. The physicians while prescribing ACE inhibitors to diabetics must take precautions to avoid complications of hyperkalemia, leading to cardiac emergencies.