Skip to main content

Research Repository

Advanced Search

Novel perspectives of sodium handling in type 2 diabetes mellitus

Hanson, Petra; Arkill, Kenton P; Merry, Catherine LR; Hussain, Mohammed S; Meersmann, Thomas; Randeva, Harpal S; Pavlovskaya, Galina E.; O’Hare, Paul; Barber, Thomas M

Novel perspectives of sodium handling in type 2 diabetes mellitus Thumbnail


Petra Hanson

Profile Image

Professor of Stem Glycobiology

Mohammed S Hussain

Professor of Translational Imaging

Harpal S Randeva

Paul O’Hare

Thomas M Barber


Introduction: As a key regulator of body water, sodium homeostasis forms an essential component of human physiology. Type 2 Diabetes Mellitus (T2D)-associated sodium overload stems from chronic renal retention of sodium, contributing toward the development of adverse cardiovascular sequelae. Areas covered: Our traditional model of sodium regulation invokes two compartments: extracellular fluid (ECF [plasma and interstitial fluid]) and intracellular fluid (ICF). Data from the Mars program reveal inconsistencies with this two-space model, including mismatches between net body sodium and water. Recent data utilizing 23Na magnetic resonance imaging (MRI) show a preponderance of bound sodium within human dermis, consistent with a third space repository and providing compelling evidence to support a three-space model in which dermal sodium binding facilitates sodium homeostasis within the ECF and ICF. This buffer is impaired in T2D, with diminishment of dermal bound sodium that may promote deleterious sequelae of sodium overload within the ECF and ICF. Expert opinion: Future studies should focus on novel therapeutic opportunities for sodium regulation in T2D and other conditions of sodium dysregulation. The ratio of free:bound dermal sodium (reflecting sodium storage capacity) could be utilized as a clinical biomarker for salt and water balance, to improve diagnostic accuracy and facilitate clinical decision-making.


Hanson, P., Arkill, K. P., Merry, C. L., Hussain, M. S., Meersmann, T., Randeva, H. S., …Barber, T. M. (2022). Novel perspectives of sodium handling in type 2 diabetes mellitus. Expert Review of Endocrinology and Metabolism, 17(4), 333-341.

Journal Article Type Article
Acceptance Date Jun 16, 2022
Online Publication Date Jun 21, 2022
Publication Date Jun 21, 2022
Deposit Date Jun 28, 2022
Publicly Available Date Jun 29, 2022
Journal Expert Review of Endocrinology and Metabolism
Print ISSN 1744-6651
Electronic ISSN 1744-8417
Publisher Informa UK Limited
Peer Reviewed Peer Reviewed
Volume 17
Issue 4
Pages 333-341
Keywords Endocrinology, Diabetes and Metabolism
Public URL
Publisher URL


You might also like

Downloadable Citations