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February 11, 2007

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Question from India:

Which neuro-hormonal changes can be common in type 2 diabetics other than pancreatic hormones? Can aldosterone levels can be effected by persistent hyperglycemia? Can some biochemical urine tests (not routine) and pH of urine be changed due to type 2 diabetes, other than sugar in urine? If yes, how?

Answer:

After a number of years, responses to hypoglycemia are decreased with decreased glucagon and epinephrine responses. Patients with type 2 diabetes are associated with marked cytokine abnormalities. Some of these may be neurally activated. The sympathetic nervous system is also upregulated in diabetes and may be part of the reason patients with neuropathy are at increased for sudden death.

JTL