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nbme21/Block 1/Question#37 (21.7 difficulty score)
A 35-year-old man with diabetic ketoacidosis ...
Serum potassium concentrationπŸ”
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 +2 
submitted by nala_ula(112),
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cienfuegos  Additional UW fun facts regarding Potassium and DKA: use caution giving insulin and IV fluids to dehydrated hyperglycemic because i forces K in cells causing fast decrease of extracellular Potassium, thus give K supplementation even when serum K elevated +3  
linwanrun1357  Why urine K+ does not decrease? +3  

This explanation is faulty. Insulin causes K to go inside via upregulating NaKATPase activity. Nothing to with H+ exchange as far as Insulin is concerned.

H and K exchange is separate from this.

+12/- b1ackcoffee(46),


 +0 
submitted by an_improved_me(13),

@blackcoffee;

Insulin does play a role in bringing back K+ into cells via modulation of K+/H+ exchange. This is because it helps to address the ketoacidotic state of the patient. By bringing pH closer to baseline, there is return of K+ into the cells, while H+ comes back out of the cells.

an_improved_me  However, you are right, in that too my knowledge, that is not the main way insulin influences K+; it is more via the NaATPase as you have mentioned. +