Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium

J. H. Helderman, D. Elahi, D. K. Andersen, G. S. Raizes, J. D. Tobin, D. Shocken, R. Andres

Research output: Contribution to journalArticle

Abstract

The effect of thiazide diuretics on the glucose tolerance of seven normal men in whom potassium loss was prevented with supplementation was studied using the glucose clamp technique. An initial control 2-h hyperglycemic clamp was performed to create a square wave of hyperglycemia 125 mg/dl above basal. At 1 h, 40 g glucose/m 2 body surface area was ingested. Serial insulin (IRI) and gastric inhibitory polypeptide (GIP) levels were measured as well as the level of glucose infusion necessary to maintain the stable hyperglycemic level. After the initial study, subjects were placed on a 10-day course of 100 mg hydrochlorothiazide and 80 meq potassium per day. Subjects were monitored for dietary potassium intake, urinary potassium, and sodium losses, and the replacement of potassium adjusted accordingly. A repeat glucose clamp was done on day 10. When potassium losses were prevented, thiazides induced no alterations in glucose tolerance, beta-cell sensitivity to glucose, GIP-cell sensitivity to glucose, beta-cell sensitivity to GIP, or tissue sensitivity to insulin. Two control studies in which hypokalemia was allowed to ensue after hydrochlorothiazide ingestion revealed a diminution in glucose tolerance, a consequence of diminished pancreatic beta-cell response to glucose. We conclude that the thiazide effect on glucose tolerance is a consequence of the resultant hypokalemia that the diuretic may create.

Original languageEnglish (US)
Pages (from-to)106-111
Number of pages6
JournalDiabetes
Volume32
Issue number2
StatePublished - 1983

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Sodium Chloride Symporter Inhibitors
Glucose Intolerance
Potassium
Maintenance
Glucose
Gastric Inhibitory Polypeptide
Thiazides
Hydrochlorothiazide
Glucose Clamp Technique
Hypokalemia
Dietary Potassium
Body Surface Area
Insulin-Secreting Cells
Diuretics
Hyperglycemia
Insulin Resistance
Eating
Sodium
Insulin

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Helderman, J. H., Elahi, D., Andersen, D. K., Raizes, G. S., Tobin, J. D., Shocken, D., & Andres, R. (1983). Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium. Diabetes, 32(2), 106-111.

Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium. / Helderman, J. H.; Elahi, D.; Andersen, D. K.; Raizes, G. S.; Tobin, J. D.; Shocken, D.; Andres, R.

In: Diabetes, Vol. 32, No. 2, 1983, p. 106-111.

Research output: Contribution to journalArticle

Helderman, JH, Elahi, D, Andersen, DK, Raizes, GS, Tobin, JD, Shocken, D & Andres, R 1983, 'Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium', Diabetes, vol. 32, no. 2, pp. 106-111.
Helderman JH, Elahi D, Andersen DK, Raizes GS, Tobin JD, Shocken D et al. Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium. Diabetes. 1983;32(2):106-111.
Helderman, J. H. ; Elahi, D. ; Andersen, D. K. ; Raizes, G. S. ; Tobin, J. D. ; Shocken, D. ; Andres, R. / Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium. In: Diabetes. 1983 ; Vol. 32, No. 2. pp. 106-111.
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