This process is accelerated by catecholamines. Glucagon Enters and Liver becomes Sugar and Ketoacid Factory Mechanism. Glucagon has actions opposite to insulin. In DKA, ketoacids, acetoacetate, and B-hydroxybutyrate act as nonresorbable anions in distal tubule and are excreted in urine as sodium and potassium salts leading to electrolyte loss. Potassium moves out of cells Mechanism Renal losses cause severe total body potassium depletion.
Potassium ions move out of the cell in exchange for hydrogen ions that move into cell.
In DKA, potassium lacks the stimulus of insulin to move into muscle. Without insulin, glycogen and protein breakdown in the cell and lead to further potassium movement out of cell. Physiology and Pathophysiology of the Human Sympathoadrenal Neuroendocrine System. Metabolic Effects of Low-Dose Insulin Therapy on Glucose Metabolism in Diabetic Ketoacidosis. Salutary Effects of Modest Fluid Replacement in the Treatment of Adults with Diabetic Ketoacidosis.