Diabetes Insipidus

Diabetes Insipidus
Diabetes Insipidus

Diabetes Insipidus

There is no relation between diabetes insipidus and insulin production. This type of diabetes related to kidney filtration.

Diabetes is a silent killer disease. Diabetic person must control his sugar level in the body, after diagnosis the diabetes and must start treatment as well under the advises of physician and principals of medical science and must not ignore, otherwise it is very harmful for human body and life as well.

What is diabetes Insipidus?


Diabetes Insipidus is a rare and unknown type of diabetes. All types of diabetes has relation to insulin production and its consumption expect this one. A person can suffer from anyone type of diabetes due to lake of insulin, insufficient insulin or insulin resistance. There is no relation between insipidus and insulin production. This type of diabetes has relation to kidney filtration disturbance.

Kidney Role in the body


The blood circulates in the body through veins and in this circulation process the blood becomes dirty. To clean the blood, the both kidneys filter the blood. Every day the kidneys filter the blood about 120 to 150 quarts. After this filtration 1 to 2 quarts turned into urine, composed of wastes and extra fluid. After filtration this urine goes from kidneys to the bladders.

When the bladder filled full capacity, the bladder sends signals to the the brain to exhaust the fluid from the bladder. An anti diuretic hormone controls the urine excreted in the bladder. This hormone called anti diuretic hormone (ADH). This anti diuretic hormone located in the part of brain. Its name is hypothalamus. Pituitary gland control this hormone and release this hormone when need.

When Diabetes Insipidus occur ?


Due to lake of anti-diuretic hormone an individual may can suffer from Insipidus diabetes. In the condition it is called central diabetes insipidus. When DI is caused by a failure of the kidneys to respond to ADH, the condition is called nephrogenic insipidus diabetes. Sometime due to some physical problems the kidneys produce more fluid than normal. In this condition some disorders developed in the body. Diabetes Insipidus is one of that disorders.

Insipidus Diabetes does not have any relation to lake of insulin or insulin resistance. Its mean that anybody can suffer from insipidus diabetes without diabetes mellitus.

Causes and symptoms of insipidus diabetes are very different from other all types of diabetes mellitus.

Main symptom and cause of diabetes insipidus is extreme thirst and frequent urination of dilute and odorless urine. Because these both symptoms are linked to diabetes, so due to this similarity of symptom, we can call this condition insipidus.

Causes of Diabetes Insipidus


Illustration of pituitary gland and hypothalamus
Pituitary gland and hypothalamus
Illustration of the female urinary system
Female urinary system


Diabetes Insipidus Signs and symptoms


This type of diabetes does not have any link to blood sugar level, it links to kidney function disturbance. There are two main signs and symptoms of this type of diabetes.

1- Polyuria

2- Polydipsia

Polyuria
Polyuria is a condition, in which the body exhaust large of quantity of urine. Each time, patient has need of urination and exhausts many litters of Liquid as urine. This exhausting is more than normal, in a day in adult persons. Normally a adult person exhaust 3 litter liquid daily.

In the insipidus diabetes condition, it affects the kidneys and the hormones that interact with them, resulting in large quantities of urine being produced.
ADH or vasopressin is an important hormone of the body. The pituitary gland located in the head, produces this Harmon. It is an Antidiuretic hormone, its main role is to controls the urine that passes from the kidneys after filration process.
ADH is a abbrivation of Anti-diuretic hormone or vasopressin. A gland pituitary creates this hormon. The role of this hormone is to control the fluid that passes from the kidneys. Due to defeciency of this harmon, quantity of urine more than normal passes from the kidneys. This condition called nephrogenic insipidus.

Polydipsia
Polydipsia is a condition in which individual drink a lot of water but he feels much thirst all the time. Drinking plenty of water will usually take care of the thirst. Sometime, we drink a little water but feel it enough, whereas, we drink a lot of water but feel more thirst. This condition called polydipsia.

In diabetes insipidus, instead of drinking enough of water the individual feels too much thirst because of excessive urination.

In the medical terminology, Polydipsia is a disease, or condition, in which the patient feel excessive thirst. In the common life every person feel thirst, sometime for the short time and sometime for long time but is a temporary condition. In the Polydipsia, the patient drink more water than normal with extra thirst. This condition indicate to sign of suffering from diabetes insipidus.

Some other signs may include; –


Patient often needs to go for urination and sometimes bed-wetting happen.

Infants and young children who are suffering from this type may have the following signs and symptoms:

Unexplained fussiness or inconsolable crying
Trouble sleeping
Fever
Vomiting
Diarrhea
Delayed growth
Weight loss


Diagnosis of Diabetes Insipidus


The polyuria condition can have linked to diabetes insipidus when urine output exceed from 3 litters /day in an adult. As when noticed that urine rate is going up than normal rate the implement therapy must adopt as early as possible to prevent the electrolyte disturbances and the associated morbidity and mortality.

In order to distinguish this type of diabetes from other forms of polyuria, several blood tests have to be ordered including the blood glucose, plasma osmolality, bicarbonatelevels, electrolytes, and urinalysis along with urine osmolality. High blood glucose levels along with an osmolar excretionrate, which is equal to urine output multiplied by urineosmolality, above 1000 mosm/d indicates osmotic diuresissecondary to hyperglycemia.

When the Diabetes Insipidus occur


When the osmolar excretion rate is less than 1000mOsm/d, two conditions have to be examined including primarypolydipsia which is associated with a serum sodium of<140meq/L and a dilute urine with urine osmolality of<100mOsm/Kg on the one hand and diabetes insipidus onthe other hand. It is associated with a serum sodium above140meq/L and a urine osmolality above 100mOsm/Kg.increase in urine osmolality.

The effect of antidiuretic hormone would be maximal when the plasma osmolality reaches 295–300 mosmol/Kg or when the serum sodium is above 145 meq/L. At this point, administering desmopressin will not further increase the urine osmolality only if we have deficient endogenous arginine vasopressin as in centraldiabetes insipidus.

Diabetes Insipidus Range Value


The urine osmolality increases to reach a value above 600mOsmol/Kg, it means that this is an appropriate response, and endogenous antidiuretic hormone is intact. The urine osmolality remains steady on 2 subsequent measurements and the plasma osmolality is rising. The plasma sodium level rises to reach a level above 145meq/L or a plasma osmolality becomebetween 295 and 300mOsmol/Kg.

Desmopressin is then given in the last two conditionseither subcutaneously or intravenously as 4 mcg orintranasally as 10 mcg. The urine volume and osmolalityand plasma osmolality are followed closely and the variations should be recorded.

Different patterns to water restriction and desmopressinadministration will help to discriminate between the different causes of polyuria.

The urine osmolality increases in complete centraldiabetes insipidus with water deprivation test, usually to more than 300mOsmol/Kg.Desmopressin leads to an increase in urine osmolality to more than 100% in complete central insipidus and 15–50% in partial central diabetes insipidus.

In nephrogenic diabetes insipidus, water deprivation test leads to a rise in urine osmolality but usually less than300mOsmol/Kg and desmopressin produces little or no change in urine osmolality.

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