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J Diabetes Complications. 2016 Aug;30(6):1158-61. doi: 10.1016/j.jdiacomp.2016.03.017. Epub 2016 Mar 17.

Effects of potassium citrate or potassium chloride in patients with combined glucose intolerance: A placebo-controlled pilot study.

Author information

1
Medizinische Universitätsklinik, Kantonsspital Bruderholz, University of Basel, CH-4101 Bruderholz/Basel Switzerland.
2
Department of Medicine, University of California San Francisco, San Francisco, CA USA.
3
Medizinische Universitätsklinik, Kantonsspital Bruderholz, University of Basel, CH-4101 Bruderholz/Basel Switzerland. Electronic address: Reto.krapf@hirslanden.ch.

Abstract

BACKGROUND:

Experimental K(+) depletion reversibly inhibits insulin secretion, while chronic metabolic acidosis decreases insulin sensitivity. We aimed to investigate the effects of potassium supplementation and alkali supplementation in non-acidotic, normokalemic humans with combined glucose intolerance.

STUDY DESIGN AND RESULTS:

In this double-blind, placebo-controlled study in 11 subjects (7 male, 4 female, ages 47-63 years), 90meqs of oral KCl or Kcitrate per day for 2weeks each increased insulin production as measured by homeostasis model assessment Beta [KCl=86 (CI 81-91), Kcitrate=88 (82-94), placebo=78 (73-83)%, p<0.04], but only Kcitrate attenuated insulin resistance as assessed by HOMA-IR (insulin resistance, Kcitrate=2.8 (2.5-3.1), placebo=3.2 (2.9-3.5), p<0.03) and only Kcitrate increased quantitative insulin sensitivity check index (Quicki, Kcitrate=0.355 (0.305-0.405), placebo=0.320 (0.265-0.375) p<0.04). These results were confirmed by independent measurements, i.e. HOMA C-peptide and whole body insulin sensitivity index measured during oral glucose tolerance testing. Kcitrate significantly decreased systolic and diastolic 24-hour ambulatory blood pressures (-4.0 (-3 to -5) and -2.7 (-1.9 to -3.5), respectively as compared to placebo, p<0.02) while KCl was without a significant effect.

CONCLUSIONS:

K(+) supplementation in the absence of overt K(+) depletion improves beta-cell function in subjects with combined glucose intolerance. The insulin-sensitizing and hypotensive effect, however, depend on citrate as the accompanying anion.

KEYWORDS:

Citrate; Combined glucose intolerance; Metabolic acidosis; Potassium; Prediabetes

PMID:
27260862
DOI:
10.1016/j.jdiacomp.2016.03.017
[Indexed for MEDLINE]

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