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March 29, 2008

Hyperglycemia and DKA, Other

Question from India:

Type 2 diabetes is, in part, based on insulin's insufficiency and sensitiveness apart from diet and exercise instabilities due to some predisposed cause. However, can persisting hyperglycemia be due to some instability of digestion, absorption and excretion besides glucose and other nutrients? One manufacturer claimed that their cough syrup also enhances antibiotic effectiveness due to some mucolytic and mucokinetic (proteolytic) action. It can be relevant in sense, if there is some instability of mucus in intestine, may be due to gastric acid and pancreas related insufficiency of digestive protease resulting decreased absorption and satiety or decreased motility, delayed emptying, gas and bloating, etc. In view of this, how can digestive enzymes having proteolytic effects (e.g., unienzyme etc.) benefit/harm diabetic patients? On the excretion side, can lesser intake of water by habit or by increased insulin AND prolonged altered vascular muscle tones or some instability in transcapillary movements cause decreased excretion of glucose resulting high blood levels?

Answer:

Yes, increased glucagon, associated with decreased insulin, is associated with increased bowel transit, increased fat breakdown, and glucagon antagonizes insulin’s effects. The biggest issue related to decreased glucose excretion is with renal insufficiency. The rest can be compensated for by movement of water across various pools.

JTL