What potential electrolyte imbalance can DKA cause?

In diabetic ketoacidosis (DKA), the body experiences a significant metabolic disturbance primarily due to insulin deficiency and elevated levels of counter-regulatory hormones such as glucagon, cortisol, and epinephrine. One of the notable electrolyte imbalances associated with DKA is hyperkalemia, not hypokalemia.

During DKA, despite the blood potassium levels being elevated, the total body potassium is often depleted. This occurs because insulin normally facilitates the movement of potassium into cells. With a lack of insulin, potassium remains in the extracellular compartment, leading to falsely elevated serum potassium levels. Therefore, when treating a patient in DKA, careful monitoring and management of potassium levels are essential.

Increased potassium levels can be dangerous, as they can lead to life-threatening cardiac arrhythmias. However, as DKA is resolved with insulin therapy and fluid resuscitation, the potassium levels typically fall, which can sometimes lead to hypokalemia if not properly monitored and supplemented if necessary.

Thus, understanding that DKA is more associated with hyperkalemia emphasizes the importance of monitoring potassium levels closely in patients undergoing treatment for this condition, rather than defaulting to the idea that hypokalemia is commonly caused by DKA.