Diabetes insipidus – Overview
Diabetes insipidus, often shortened to DI, is a rare form of diabetes that is not related to blood sugar-related diabetes mellitus, but does share some of its signs and symptoms. Diabetes insipidus is simply excessive urination (polyuria) and complications thereof, caused by an antidiuretice hormone called a vasopressin.
Diabetes insipidus wiki
Diabetes insipidus (DI) is a condition characterized by large amounts of dilute urine and increased thirst. The amount of urine produced can be nearly 20 liters per day. Reduction of fluid has little effect on the concentration of the urine. Complications may include dehydration or seizures.
What are the types of diabetes insipidus
Neurogenic or central Diabetes Insipidus: This type of DI is caused by a lack of AVP or arginine vasopressin production in the brain. AVP is a hormone that controls retention of water in the body.
Nephrogenic Diabetes Insipidus: This type of DI is caused by an insensitivity of ones kidneys to AVP. The kidneys do not respond properly to this antidiuretic hormone causing water loss.
Dipsogenic DI: This type of DI is caused by a defect or injury in the thirst mechanism located in the hypothalamus gland in the brain. This causes an increase in thirst and fluid intake that causes a suppression of AVP production and increases urine output.
Gestational DI: This DI type only occurs during pregnancy. Pregnant women produce an enzyme called vasopressinase. This enzyme breaks down AVP. It is thought that Gestational DI is a result of an overproduction of vasopressinase.
Central diabetes insipidus
Central diabetes insipidus is a lack of the hormone vasopressin (antidiuretic hormone) that causes excessive production of very dilute urine (polyuria). Central diabetes insipidus has several causes, including a brain tumor, a brain injury, brain surgery, tuberculosis, and some forms of other diseases.
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Nephrogenic diabetes insipidus
Dipsogenic diabetes insipidus
Dipsogenic diabetes insipidus is a syndrome of disordered thirst, in patients without psychiatric disease, which may be confused with partial central diabetes insipidus. Distinguishing these entities involves monitored water testing. Therapy with antidiuretic hormone in patients with dipsogenic diabetes insipidus is thought to be contraindicated for fear of inducing water intoxication.
Gestational diabetes insipidus
Gestational diabetes insipidus (GDI) is a rare complication of pregnancy affecting 2–4 per 100 000 pregnancies. It tends to occur at the end of the second trimester or during the third trimester. GDI is usually transient with spontaneous resolution 4–6 weeks after delivery.
How do you diagnose diabetes insipidus?
A health care provider can diagnose a person with diabetes insipidus based on a medical and family history, a physical exam, urinalysis, blood tests, a fluid deprivation test, and magnetic resonance imaging (MRI). The primary treatment for diabetes insipidus involves drinking enough liquid to prevent dehydration.
What is the most common cause of diabetes insipidus?
Diabetes insipidus symptoms and causes: Damage to the pituitary gland or hypothalamus from surgery, a tumor, a head injury or an illness can cause central diabetes insipidus by affecting the usual production, storage and release of ADH. An inherited genetic disease can also cause this condition.
What is difference between diabetes insipidus and mellitus?
Diabetes mellitus occurs due to insulin resistance or insulin deficiency and subsequent high blood glucose levels. Diabetes Insipidus on the other hand develops as a result of the stilted production of a hormone in the brain, which is released to stop the kidneys producing so much urine in order to retain water
Diabetes mellitus is a chronic metabolic disorder that prevents the body to utilize glucose completely or partially. It is characterized by raising glucose concentration in the blood and alterations in carbohydrate, protein and fat metabolism. This can be due to failure in the formation of insulin or liberation or action. Since insulin is produced by the ² cells of the islets of Langerhans, any receding in the number of functioning cells will decrease the amount of insulin that can be synthesized.
Many diabetics can produce sufficient insulin but some stimulus to the islets tissue is needed in order that secretion can take place. In the early stages of the disease the Insulin Like Activity (ILA) of the blood is often increased, but most of this insulin appears to be bound to protein and is not available for transport across the cell membrane and action of the cell.
The hormones of the anterior pituitary, adrenal cortex, thyroid and ± cells of the islets of Langerhans are glucogenic, that is, they increase the supply of glucose. Possibly they could increase the demand, decrease the secretion or antagonize and inhibit the action of insulin. The body releases hormones that raise blood glucose levels to provide a quick source of energy for coping with stress. In the stress conditions diabetes mellitus may precipitate with genetic predisposition.
Diabetes Insipidus is a condition that shares some of the symptoms of diabetes mellitus, large urine output, great thirst and sometimes a large appetite. But in diabetes insipidus these are symptoms of a specific injury, not a collection of metabolic disorders. The impaired pituitary gland produces less anti-diuretic hormone, a substance that normally helps the kidneys retain water.
Diabetes insipidus vs siadh
SIADH and DI are both disorders of water regulation affecting the activity or release of antidiuretic hormone (ADH) in the body. ADH secretion is normally inhibited in response to water intake. In SIADH, ADH is not suppressed resulting in water retention and significant electrolyte abnormalities. In DI, there is either decreased production of ADH (central DI), or normal ADH secretion with resistance in the kidneys to its effects (nephrogenic DI). The net result of DI is large volume diuresis of dilute urine.
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Symptoms of diabetes insipidus?
Diabetes insipidus symptoms and causes are characterized by extreme versions of a few very common Diabetes Mellitus symptoms. These include:
- Extreme and often excessive thirst for cold water and sometimes even ice water
- Excessive urination due to extreme consumption of water.
- Fever
- Vomiting
- Diarrhea
- Dehydration
The symptoms of Diabetes Insipidus mimic those of Diabetes Mellitus however one main distinction is that the urine will not contain excess glucose and hyperglycemia or, high blood sugar, will not be evident. Signs of dehydration are often the best indicator as sufferers of this disease are often unable to conserve any amount of water in large quantities.
As a result of the extreme loss of liquids, Diabetes Insipidus can interfere with ones daily life. Constantly going to the bathroom can affect ones work life, appetite, and sometimes can affect growth in children. Depletion of electrolytes is also of large concern and is another excellent symptom of Diabetes Insipidus to watch for.
The diagnosis of Diabetes Insipidus is both qualitative and quantitative involving both the documentation of the above listed symptoms as well as hormone-level testing to determine the type (if any) of DI in each case.
How do you test for diabetes insipidus?
If you have diabetes insipidus, you'll continue to pee large amounts of dilute urine when normally you'd only pee a small amount of concentrated urine. During the test, the amount of urine you produce will be measured. You may also need a blood test to assess the levels of antidiuretic hormone (ADH) in your blood.
Diabetes insipidus investigations
Baseline investigations should include urea and electrolytes, full ward test of urine and paired serum and urine osmolality. Diabetes insipidus is present when the serum osmolality is raised (>295milliOsmol/kg) with inappropriately dilute urine (urine osmolality
Diabetes insipidus treatment guidelines
Most patients with diabetes insipidus (DI) can drink enough fluid to replace their urine losses. When oral intake is inadequate and hypernatremia is present, replace losses with dextrose and water or an intravenous (IV) fluid that is hypo-osmolar with respect to the patient's serum.
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Diabetes insipidus treatment involves having a good and plentiful source of fluid. In the case of neurogenic DI the drug desmopressin is taken to control the frequent thirst and urination.
There is no natural cure for diabetes insipidus but it doesn’t pose any serious complications to the health if the person can take on fluids whenever they feel thirsty. It is confused with diabetes mellitus because the symptoms are similar but testing will determine which disease the person may be afflicted with.
For treatment naturally, Diabetes Freedom can be thought of as a step-by-step program that is designed to help users get rid of the various symptoms that are directly related to this deadly disease.
