INS and urinary tract infection: Resultant calorie deficits can lower insulin secretion and enhance release of counter-regulatory hormones such as catecholamines, cortisol, glucagon, and growth hormone.[12] Urinary tract infection in patients with type 2 DM can be accompanied by relative insulin deficiency, which leads to ketoacid formation through increase of lipolysis and free fatty acids.[13] Concomitant elevation in serum counter-regulatory hormones promotes the urinary loss of glucose, resulting in euglycemia.