INS and diabetes mellitus: Uric acid stones were known to be more prevalent in diabetic patients.[8–9] The relation between DM and uric acid nephrolithiasis was attributed to the effects of insulin resistance on urine pH and the renal handing of ammonium and calcium.[8, 10] Insulin was known to simulate the synthesis of ammonia in the renal tubule that mediates ammonium excretion in urine.