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In diabetes the rate of glucose uptake is slowed, the level of circulating blood sugar rises, and sugar spills over into the excreted urine. Calories are wasted, more water is excreted, and there is muscular weakness and weight loss; hence urinary frequency, hunger, thirst, and fatigue. Whenever glucose metabolism is defective, stored fat is broken down to fatty acids because of the actions of adrenaline and the pituitary growth hormone.