A patient was recently diagnosed with type 1 diabetes mellitus and received insulin. Which laboratory test will the nurse assess?
A. Potassium
B. AST (aspartate aminotransferase)
C. Serum amylase
D. Sodium
Correct Answer: A. Potassium
Insulin causes potassium to move into the cell and may cause hypokalemia. Insulin shifts potassium into cells by stimulating the activity of Na+-H+ antiporter on cell membrane, promoting the entry of sodium into cells, which leads to activation of the Na+-K+ ATPase, causing an electrogenic influx of potassium. IV insulin leads to a dose-dependent decline in serum potassium levels
Option B: In type 2 diabetes, in the absence of detectable steatosis by ultrasonography, ALT and AST are associated with hyperinsulinemia and insulin resistance, independent of obesity. This finding possibly indicates that in diabetes a mild stage of steatosis is sufficient to mediate the association between insulin resistance and aminotransferases.
Option C: Insulin can minimally affect amylase activity. People with diabetes whose insulin-secreting beta cells in the pancreas are working well have higher amylase levels (within the normal range). Animal studies show that insulin increases amylase production
Option D: The primary action of insulin on sodium balance is exerted on the kidney. Increases in plasma insulin concentration within the physiological range stimulate sodium reabsorption by the distal nephron segments and this effect is independent of changes in circulating metabolites or other hormones.
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