Hyperkalemia after triamterene in diabetic patients

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Abstract
Eleven patients with maturity‐onset diabetes mellitus and 6 normal subjects were studied to determine whether they would develop abnormal serum potassium or glucose levels in response to triamterene, to an acute glucose load, or to an acute glucose load during triamterene therapy. The response in each case depended on the presence of diabetes and the degree of glucose intolerance before triamterene. The normal subjects and mild diabetic patients showed no change in pattern of response to glucose load after triamterene, while the moderate diabetic patients displayed certain metabolic changes under the same experimental conditions. Triamterene caused a minor, reversible increase in serum potassium in all subjects but an increase in fasting blood sugar only in the moderate diabetic patients. In all groups there was a decline in creatinine clearance after 7 days on triamtercne. In addition, the moderate diabetic patients developed hyperkalemia during an intravenous glucose tolerance test while on triamterene therapy. Only one of the moderate diabetic patients developed hyperkalemia during an oral glucose tolerance test. Possible mechanisms for these effects are discussed and the use of triamterene in diabetes mellitus is assessed.

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