The diagnostic value of alterations in potassium and phosphate levels during an oral glucose tolerance test for hyperinsulinemia
Keywords:Diabetes mellitus, hyperinsulinemia, oral glucose tolerance test, phosphate, potassium
Objective: We aimed to test whether the potassium and phosphate level alterations during the OGTT test are useful to diagnose hyperinsulinemia/insulin resistance.
Materials and methods: The study comprised patients who applied at our clinic for obesity or hyperglycemia and were scheduled for an oral glucose tolerance test (OGTT) because of high HbA1c levels or impaired fasting glucose levels. During the OGTT, blood glucose, insulin, potassium and phosphate patterns were measured at 0-30-60-90 and 120 minutes. Then potassium (K) and phosphate (P) changes were calculated (ΔK and ΔP).
Results: A total of 58 patients were included in the study, 63.8% (37 patients) were female and 36.2% (21 patients) were male. Mean age: 14.35±1.83 years, 79.3% were obese. A significant difference was found in the 90 min phosphate, ΔP2, and ΔP3 values of the patients with hyperinsulinemia were compared to the patients without hyperinsulinemia (respectively; p=0.018; p=0.040; p=0.005). There was no difference between ΔK values of the patients with and without hyperinsulinemia. While potassium level decreased to 3.6 mmol/L during OGTT, phosphate level decreased to 1.8 mg/dl.
Conclusions: ΔP2 and ΔP3 can be used as additional diagnostic parameters in the diagnosis of hyperinsulinemia. Phosphate and potassium should be checked before the test, as hypokalemia and hypophosphatemia may develop, especially in patients with significant hyperinsulinemia during the OGTT.
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