Effects of potassium supplements on glucose metabolism in African Americans with prediabetes: a pilot trial

Abstract

Background: Low potassium has been identified both as a risk factor for type 2 diabetes and as a mediator of the racial disparity in diabetes risk. Low potassium could be a potentially modifiable risk factor, particularly for African Americans. Objective: We sought to determine the effects of potassium chloride (KCl) supplements, at a commonly prescribed dose, on measures of potassium and glucose metabolism. Design: Among African-American adults with prediabetes, we conducted a double-blinded pilot randomized controlled trial that compared the effects of 40 mEq K/d as KCl supplements with a matching placebo, taken for 3 mo, on measures of potassium and glucose metabolism, with measures collected from frequently sampled oral-glucose-tolerance tests (OGTTs). Results: Twenty-seven of 29 recruited participants completed the trial. Participants had high adherence to the study medication (92% by pill count). Participants in both groups gained weight, with an overall mean 6 SD weight gain of 1.24 6 2.03 kg. In comparison with participants who received placebo, urine potassium but not serum potassium increased significantly among participants randomly assigned to receive KCl (P = 0.005 and 0.258, respectively). At the end of the study, participants taking KCl had stable or improved fasting glucose, with a mean 6 SD change in fasting glucose of 21.1 6 8.4 mg/dL compared with an increase of 6.1 6 7.6 mg/dL in those who received placebo (P = 0.03 for comparison between arms). There were no significant differences in glucose or insulin measures during the OGTT between the 2 groups, but there was a trend for improved insulin sensitivity in potassium-treated participants. Conclusions: In this pilot trial, KCl at a dose of 40 mEq/d did not increase serum potassium significantly. However, despite weight gain, KCl prevented worsening of fasting glucose. Further studies in larger sample sizes, as well as with interventions to increase serum potassium more than was achieved with our intervention, are indicated to definitively test this potentially safe and inexpensive approach to reducing diabetes risk. This trial was registered at clinicaltrials.gov as NCT02236598.

An association of urinary sodium-potassium ratio with insulin resistance among Korean adults

“…Since there are no studies examining the effect of sodium-potassium ratio on insulin resistance or insulin sensitivity, previous studies examined the effects of sodium or potassium on insulin resistance or insulin sensitivity, respectively. Several studies reported a positive association of high-sodium diet [ 6 7 8 9 ] or low-potassium diet [ 10 11 ] with insulin resistance that cohere with these results. Sodium intake estimated by the urinary sodium to urinary creatinine ratio was positively associated with insulin resistance among Korean children or adolescents [ 30 31 ].…”

“…Wan Z et al [ 9 ] conducted a clinical trial to examine the effects of sodium and potassium on insulin resistance during 7 days, and found that a high salt diet was positively associated with insulin resistance and potassium supplements inversely associated with insulin resistance. Chatterjee R et al [ 10 ] piloted a double-blinded randomized controlled trial to compare the effects of potassium supplements (40 mEq K/d) with matching placebo during 3 months, and found a significant trend for improved insulin sensitivity among the potassium-treated group. On the other hand, no associations between sodium and insulin resistance [ 15 16 ] and negative associations between sodium and insulin resistance [ 11 12 13 14 ] were reported by several studies.…”

“…Several studies suggest that high sodium diet [ 6 7 8 9 ] and low potassium diet [ 9 10 ] are positively associated with insulin resistance, while others show an inverse association between sodium diet and insulin resistance [ 11 12 13 14 ] or provide no evidence of these associations [ 15 16 ]. In addition, according to the 2015 Korea National Health and Nutrition Examination Survey, Koreans had a higher sodium intake (327% in men, 228% in women) and lower potassium intake (96% in men, 78% women) compared with the Adequate Intake of dietary sodium and potassium [ 17 ].…”

Health promotion interventions for African Americans delivered in U.S. barbershops and hair salons- a systematic review

“…Socioeconomic status (SES) was reported by all but two studies. Participants in three studies were reported as having only a high school education or less, low-income, and/or mostly uninsured [ 20 , 54 , 55 ]. Studies were mostly conducted in large urban/metropolitan cities with only one in a rural area [ 20 ].…”

Bioactive Compounds, Nutritional Value, and Potential Health Benefits of Indigenous Durian (Durio Zibethinus Murr.): A Review

“…A meta-analysis study showed that there was a linear dose-response between low serum potassium and risk of type 2 diabetes mellitus [54]. Chatterjee et al (2017) demonstrated that potassium chloride supplementation reduced the worsening effect of fasting glucose in African-Americans compared with placebo [55]. Collectively, the evidence has shown that potassium content in durian might play a role in the regulation of blood glucose.…”