| A case of type 2 diabetes manifested by hypokalemic periodic paralysis |
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Dong Han Yeom, Ha Young Kim, Byoung Hyun Park, Chung Gu Cho |
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| 저칼륨혈증성 주기성 마비로 발현된 제2형 당뇨병 1예 |
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염동한 &#; 김하영 &#; 박병현 &#; 조정구, Ha Young Kim, Byoung Hyun Park, Chung Gu Cho |
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| Abstract |
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Hypokalemic periodic paralysis may be precipitated by stress, rest after exercise, or events that lower serum potassium levels, such as
carbohydrate ingestion or the use of insulin or diuretics. In healthy subjects, insulin activates Na+/K+ ATPase, which elicits potassium influx
and transient hypokalemia; however, hypokalemia is compensated by K+ ATP channel activation. Recently, we encountered a
49-year-old male patient with type 2 diabetes mellitus and hyperinsulinemic hypokalemic periodic paralysis. The patient had no family
history of muscle weakness or diabetes mellitus. At the time of the attack, plasma glucose was 142.4 mg/dL, plasma insulin was 116.86
μIU/mL, serum potassium was 2.08 mEq/L, and thyroid hormone, renin, aldosterone, ACTH, and cortisol levels were normal. Symptoms
improved rapidly upon potassium replacement. Oral glucose tolerance testing revealed high glucose and insulin levels at 2 h, and serum
potassium and phosphate levels decreased from 5.1 to 4 mEq/L and 3.6 to 2.0 mg/dL, respectively. (Korean J Med 76:499-501, 2009) |
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