DIABETES INSIPIDUS

By Bruna Corrales

Definitons

Diabetes Insipidus ≠ Diabetes Mellitus

From the Greek:Diabainein -"to pass through“

From Latin:Insipidus - "having no flavor"

Diabetes Insipidus occurs when this precise system for regulating the kidneys' handling of fluids is disrupted.

Normal Production of ADH

Central DI, Nephrogenic DI, Dipsogenic DI and Gestational DI.

Four types of Diabetes Insipidus

Central DI

Most common and serious type of DI.

Results from damage to the pituitary gland.

Disrupts the normal storage and release of ADH.

Causes : different diseases as well as by head injuries, neurosurgery, or genetic disorders.

Tratment: Demopressin (synthetic antidiuretic ).

Prevented : Helmets, sit belts and other protective equipaments.

Nephrogenic DI

Results when the kidneys are unable to respond to ADH.

Cause :drugs (such as lithium) , chronic and inherited genetic disorders.

Sometimes the cause of Nephrogenic DI is never discovered.

Treatment : low-salt diet to reduce the amount of urine produced by the kidneys and diuretic called Hydrochlorothiazide (HCTZ).

Prevention: Any known way.

Dipsogenic DI

Uncommon type of DI

Results in an abnormal increase in thirst and fluid intake that suppresses ADH secretion and increases urine output.

Cause: defect in or damage to the thirst mechanism, which is located in the hypothalamus.

Treatment: no known long-term treatment.

Can’t use drugs prescribed to the other types of DI because they may decrease urine output but not the patient's thirst and fluid intake. At water intoxication can happen, reducing the concentration of sodium in the blood. It can seriously damage the patient's.

Prevention: Any known way

Gestational DI

Occurs only during pregnancy

Results when an enzyme made by the placenta destroys ADH in the mother.

Treatment: Demopressin.

Prevention: Any known way.

Symptoms and Signs

Normal person - 2.6 quarts (about 2.5 liters) of urine

Diabetes insipidus - 16 quarts (about 15 liters) of urine

Extreme thirst Excretion of an excessive amount of diluted urine

Diagnoses ( tests and exams)

Laboratory examination urine. Laboratory blood examination.

Miller-Moses, the water deprivation test.

magnetic resonance imaging (MRI) .

Prognosis

Health adults : Low rates of death Patients usually have normal lives, as long there is water

available

People with other illnesses, children and the elderly : Dehydration High levels of sodium in the blood Fever Cardiovascular collapse Eventual death

Pregnant woman : Risk of preeclampsia and other complications of pregnancy. Should follow carefully the doctor’s recommendation.

Prognosis

Be mindful of the importance of balancing salt and water intake.

Extra precautions against dehydration in hot weather .

Treat vomiting or diarrhea promptly when traveling.

Carry a medical alert card or wear a medical alert bracelet.