본 저자들은 인슐린 과반응에 의한 고인슐린혈증에 의한 저칼륨혈증성 주기성 마비로 처음 제2형 당뇨병을 진단받은 49세 남자 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Hypokalemic periodic paralysis may be precipitated by stress, rest after exercise, or events that lower serum potassium levels, such as carbohydrate ingestion or the use of insulin or diuretics. In healthy subjects, insulin activates Na+/K+ATPase, which elicits potassium influx and transient hypokalemia; however, hypokalemia is compensated by K+ATP channel activation. Recently, we encountered a 49-year-old male patient with type 2 diabetes mellitus and hyperinsulinemic hypokalemic periodic paralysis. The patient had no family history of muscle weakness or diabetes mellitus. At the time of the attack, plasma glucose was 142.4 mg/dL, plasma insulin was 116. 86 uIU/mL, serum potassium was 2.08 mEq/L, and thyroid hormone, renin, aldosterone, ACTH, and cortisol levels were normal. Symptoms improved rapidly upon potassium replacement. Oral glucose tolerance testing revealed high glucose and insulin levels at 2 h, and serum potassium and phosphate levels decreased from 5.1 to 4 mEq/L and 3.6 to 2.0 mg/dL, respectively. (Korean J Med 76:499-501, 2009)