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What Causes Elevated Cytokines And Adrenaline In A Diabetic Patient?
Question: In type 2 diabetes, diabetic ketoacidosis is associated with impaired insulin secretion and insulin action and when treated insulin production is resumed and the patient can continue with their normal treatment of diet and drugs if they take drugs.
But insulin deficiency and/or inaction is not the whole of the story. There is also large increases of the hormones glucagon and adrenaline. Why?
Also there are cytokines, which leads to increased markers of inflammation,
even in the absence of infection. How is this explained?
I can understand the presence of adrenaline and the cytokines, but only if there is the perception of danger inside the body; a fear reaction would give rise to adrenaline and if the fear is erroneously perceived to be internal then the reason for the inflammatory response.
But insulin deficiency and/or inaction is not the whole of the story. There is also large increases of the hormones glucagon and adrenaline. Why?
Also there are cytokines, which leads to increased markers of inflammation,
even in the absence of infection. How is this explained?
I can understand the presence of adrenaline and the cytokines, but only if there is the perception of danger inside the body; a fear reaction would give rise to adrenaline and if the fear is erroneously perceived to be internal then the reason for the inflammatory response.
Brief Answer:
Hi
Detailed Answer:
Good day.
Apologies for delay in answer. This is basically due to the time zone difference. I just noticed your question.
To answer your question, DKA is relatively rare in Type 2 when compared to Type 1 diabetes. However, I myself have seen a number of Type 2 diabetes patients having DKA. This is due to relative Insulin deficiency or resistance. It usually occur during an episode of serious illness like a pneumonia or urinary tract infection.
Adrenaline is a stress hormone which increases when there is a serious stress situation like infection or in severe mental pressure. This is a counter regulatory hormone which blocks the action of Insulin.
Glucagon is produced by pancreas and Insulin prevents excess secretion of glucagon. When there is relative insulin deficiency, there is large amount of glucagon secretion which adds to the pathophysiology of DKA. When we start insulin infusion in DKA, glucagon secretion is blocked.
Cytokines are inflammatory mediators which are released when there is an infection, inflammation, trauma and in severe stress. So even in the absence of infection, if there is a trauma or other inflammatory lesions ( eg: arthritis ), cytokines are released.
Regards
Binu
Hi
Detailed Answer:
Good day.
Apologies for delay in answer. This is basically due to the time zone difference. I just noticed your question.
To answer your question, DKA is relatively rare in Type 2 when compared to Type 1 diabetes. However, I myself have seen a number of Type 2 diabetes patients having DKA. This is due to relative Insulin deficiency or resistance. It usually occur during an episode of serious illness like a pneumonia or urinary tract infection.
Adrenaline is a stress hormone which increases when there is a serious stress situation like infection or in severe mental pressure. This is a counter regulatory hormone which blocks the action of Insulin.
Glucagon is produced by pancreas and Insulin prevents excess secretion of glucagon. When there is relative insulin deficiency, there is large amount of glucagon secretion which adds to the pathophysiology of DKA. When we start insulin infusion in DKA, glucagon secretion is blocked.
Cytokines are inflammatory mediators which are released when there is an infection, inflammation, trauma and in severe stress. So even in the absence of infection, if there is a trauma or other inflammatory lesions ( eg: arthritis ), cytokines are released.
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You said cytokines are released when there is an infection, inflammation, trauma and in severe stress. I am interested in the case of severe stress. Do you mean that there is no trauma, infection etc., but the person is stress due to issues and problems in their life?
I have seen that when a person reacts to ideas the reaction is in the body. So in the presence of danger issues any concurrent ideas of harm cause the immune system to become over-reactive and attack some area of the body. Have you seen inflammation where it is unnecessary? Could type 1 diabetes be caused in this way? I know it is not mainstream medical thinking.
I have seen that when a person reacts to ideas the reaction is in the body. So in the presence of danger issues any concurrent ideas of harm cause the immune system to become over-reactive and attack some area of the body. Have you seen inflammation where it is unnecessary? Could type 1 diabetes be caused in this way? I know it is not mainstream medical thinking.
Brief Answer:
Hi
Detailed Answer:
Good day,
Thank you for the reply.
Yes, mental stress some times can be strong enough to modify our immune system. However, whether this cause auto immunity is not proven.
Sever mental stress has been shown to rise the level of cortisol, adrenalin and cytokines as well. The same can precipitate DKA. Cytokines can attack body tissues and expose certain tissues to the charged immune system. In that way, auto immunity indeed is possible. There is an interesting article to read on it. Please visit this website
http://www.aabgu.org/media-center/news-releases/stress-autoimmune-disease.html
Regards
Binu
Hi
Detailed Answer:
Good day,
Thank you for the reply.
Yes, mental stress some times can be strong enough to modify our immune system. However, whether this cause auto immunity is not proven.
Sever mental stress has been shown to rise the level of cortisol, adrenalin and cytokines as well. The same can precipitate DKA. Cytokines can attack body tissues and expose certain tissues to the charged immune system. In that way, auto immunity indeed is possible. There is an interesting article to read on it. Please visit this website
http://www.aabgu.org/media-center/news-releases/stress-autoimmune-disease.html
Regards
Binu
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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