Diabetes insipidus : Definition, sign, causes and treatment


Diabetes insipidus is when the body can not control or regulate the flow of fluids such as urine of which this is totally different from normal diabetes. It also cause intense thirsty as there's no regulation of body fluid. A healthy person urinate like 1 to 2 quarts daily,but people with diabetes insipidus can urinate more than 10 times daily, because the hormones which help regulate fluid is weak and not functional.

General Signs of Diabetes insipidus.

- Extreme thirsty. If you are infected with diabetes insipidus,you will experience extreme thirst as the fluid in your body is no longer controlled. 

- urinating frequently. The hormones regulating the fluid is no longer effective,it will lead to frequent passing of urine.

- Restlessness. Frequently visiting of the rest room to ease yourself can be frustrating.

- colorless urine

- weakness. There won't be enough fluid the lubricate the joint,that can lead to fatique and tiredness

- Dehydration. For the fact that there is always loss of fluid in the body that can lead to dryness of the body, which can cause dizziness etc

 Diabetes also affect infants, unlike normal diabetes milletus which have age range.

Signs of diabetes in infants

- slow growth. An infant that's affected with diabetes insipidus will experience poor/slow growth. As the hormones necessary for regulating the fluid is not functional,the child will lack body fluid which aid in digestion

- poor feeding. There won't be quest for food as the body is unconditional.

- weight loss. The child will loose alot of weight because of poor feeding habit.

- crankiness. The child will be having a bad disposition and sometimes hot tempered.

- vomiting.

- Drinking alot of water

- Bed wetting

- frequent urinating

- loss of energy

Causes of diabetes insipidus

Your body makes a hormone called vasopressin in a part of your brain called the hypothalamus. It’s stored in your pituitary gland. Vasopressin tells your kidneys to hold on to water, which makes your urine more concentrated. (Vasopressin is also called antidiuretic hormone or ADH.)

When you’re thirsty or a little dehydrated, your vasopressin levels go up. Your kidneys absorb more water and put out concentrated urine. If you’ve had enough to drink, vasopressin levels fall, and what comes out is clear and diluted.

When the body doesn’t make enough vasopressin, the condition is called central diabetes insipidus. Anyone can get central DI, but it's not common. Only about 1 in every 25,000 people gets it.

If you make enough but your kidneys don’t respond to it the way they should, you have nephrogenic diabetes insipidus.

In either form, the result is the same. Your kidneys can't keep water, so even if you’re dehydrated, they'll put out a lot of pale urine

Types of Diabetes Insipidus

  • Central diabetes insipidus. You get this when damage to your hypothalamus or pituitary gland affects how your body makes or puts out vasopressin. Your kidneys remove too much fluid from your body, and you pee more. This damage can result from:
    • A tumor
    • A head injury
    • A blocked or bulging artery (aneurysm)
    • Diseases such as Langerhans cell histiocytosis
    • Infection
    • Inflammation
    • Surgery
  • Nephrogenic diabetes insipidus. You get this when your kidneys don’t respond to vasopressin and take too much fluid from your bloodstream. Doctors don’t always know why it happens, but some causes include:
    • A blocked urinary tract
    • Chronic kidney disease
    • High levels of calcium in your blood
    • Low levels of potassium in your blood
    • Some medications, like lithium
  • Dipsogenic diabetes insipidus. This type, also known as primary polydipsia, happens when your body has trouble controlling thirst. When you drink, the liquid lowers the amount of vasopressin that your body makes, while making you pee more. Causes include damage to your hypothalamus or pituitary glands from:
    •  head injury
    • Infection
    • Inflammation
    • Surgery
  • Some medications or mental health problems could make you more likely to get dipsogenic diabetes insipidus.

  • Gestational diabetes insipidus. You get this type only during pregnancy. Sometimes, a woman’s placenta -- the organ that gives oxygen and nutrients to your baby -- makes an enzyme that breaks down vasopressin. Other pregnant women make more prostaglandin, a hormone-like chemical that makes their kidneys less sensitive to vasopressin. Most cases of gestational diabetes insipidus are mild and don’t cause clear symptoms. The condition usually goes away after birth, but it might come back in another pregnancy.
    

Treatment

Treatment options depend on the type of diabetes insipidus you have.

  • Central diabetes insipidus. If you have mild diabetes insipidus, you may need only to increase your water intake. If the condition is caused by an abnormality in the pituitary gland or hypothalamus (such as a tumor), your doctor will first treat the abnormality.

    Typically, this form is treated with a synthetic hormone called desmopressin (DDAVP, Nocdurna). This medication replaces the missing anti-diuretic hormone (ADH) and decreases urination. You can take desmopressin in a tablet, as a nasal spray or by injection.

    Most people still make some ADH, though the amount can vary day to day. So, the amount of desmopressin you need also may vary. Taking more desmopressin than you need can cause water retention and potentially serious low-sodium levels in the blood.

    Other medications might also be prescribed, such as chlorpropamide. This can make ADH more available in the body.

  • Nephrogenic diabetes insipidus. Since the kidneys don't properly respond to ADH in this form of diabetes insipidus, desmopressin won't help. Instead, your doctor may prescribe a low-salt diet to reduce the amount of urine your kidneys make. You'll also need to drink enough water to avoid dehydration.

    Treatment with the drug hydrochlorothiazide (Microzide) may improve your symptoms. Although hydrochlorothiazide is a type of drug that usually increases urine output (diuretic), it can reduce urine output for some people with nephrogenic diabetes insipidus.

    If your symptoms are due to medications you're taking, stopping these medicines may help. However, don't stop taking any medication without first talking to your doctor.

  • Gestational diabetes insipidus. Treatment for most people with gestational diabetes insipidus is with the synthetic hormone desmopressin.
  • Primary polydipsia. There is no specific treatment for this form of diabetes insipidus, other than decreasing fluid intake. If the condition is related to a mental illness, treating the mental illness may relieve the diabetes insipidus symptoms.


Sources
WebMD: causes of diabetes insipidus and types of diabetes insipidus
Mayoclinic: treatment of diabetes insipidus


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