
February 26, 2007
Other, Type 2
Question from India:
Can it be possible that a type 2 diabetic with hyperglycemia loses more of those nutrients in urine, which are prominent in intracellular fluid (ICF), i.e., potassium, magnesium, phosphate, sulfates/proteins etc., and conserve those which are in prominent in extracellular fluid (ECF), such as sodium, chloride, bicarbonate, etc.? This may be due to the redistribution in between ICF and ECF due to hyperglycemia resulted hypertonicity of ECF. ECF/ICF’s pH should also get affected in this way.
Answer:
Extracellular nutrients are lost in times of osmotic diuresis when glucose is high in plasma. Because water moves down its concentration gradient, some intracellular fluid and electrolytes come with it and are also lost in the urine through golumerular filtration. Marked loss of potassium and phosphate are examples of intracellular electrolytes lost during periods of marked hyperglycemia.
JTL