Diabetes Insipidus
Diabetes Insipidus is a disease classified as diabetes but not related to the common types of diabetes. It is the result of the body not producing, storing or releasing a key hormone ADH (antidiuretic hormone also called AVP arginine vasopressint. This is the hormone that affects the kidneys). The kidneys are unable to respond to this hormone causing a deficiency resulting in the condition known as diabetes insipidus. The kidneys are most effected therefore diabetes insipidus is primarily a kidney disease. The characteristics of diabetes insipidus are excessive severe thirst (usually the person cannot get enough water and they mostly crave very cold water, ice water or just ice) and excretion of large amounts of urine that is severely diluted. Persons with diabetes insipidus can excrete if the condition is mild, up to 2.6 quarts of urine per day or if severe up to 16 quarts and this will go on day and night frequently having to go to the bathroom. Even if the person has a reduced fluid intake this will not have an effect on the amount of urine excreted.
Diabetes insipidus includes two different types with the most common being central diabetes insipidus or CDI as it is called, caused by a deficiency of arginine vasopressin or AVP, the hormone that affects the kidneys also known as antidiuretic hormone or ADH. Nutritionist students study ADH in great detail. The second type is called nephrogenic diabetes insipidus. This is a disease of the kidney caused by an improper response of the kidney to the antidiuretic hormone (ADH) leading to a decreased ability of the kidney to concentrate urine. Diabetes insipidus is classified into four different classifications. They are: neurogenic diabetes insipidus also known as central diabetes insipidus. This condition caused by a lack of vasopressin production in the brain is the most common type. Nephrogenic diabetes insipidus is the inability of the kidneys to respond to the antidiuretic hormone ADH. Dispogenic diabetes insipidus is due to a defect or damage in the hypothalamus of the brain that regulates thirst, and gestational diabetes insipidus only occurs in pregnancy when the pregnant woman produces too much vasopressin in the placenta thereby breaking down the antidiuretic hormone ADH resulting in an extreme form of gestational diabetes insipidus. The good news is that this type of diabetes generally leaves the woman within 4 to 6 weeks of giving birth. However in some instances medical treatment is necessary.
Diagnosis of diabetes insipidus includes a battery of medical tests to determine if the patient has the condition and if so at what stage of severity has diabetes insipidus progressed to. The common tests conducted are: the blood glucose test to determine the level of blood glucose in the blood, the bicarbonate (chemical acid) test to check for acidic levels in the blood, and the calcium test to detemine calcium levels. Blood electrolytes are also measured and a urinalysis taken to determine diabetes insipidus present in urine. Unlike diabetes mellitus where there is a sweet smell of urine due to excessive amount of glucose or polysuria with diabetes insipidus there is no smell of sweetness in the urine. Persons with any of the common symptoms of diabetes should immediately be checked out for the possibility of diabetes insipidus or any other form of diabetes.
Treatment for diabetes insipidus is based on a drug regimen predicated on what classificaiton of diabetes insipidus the patient has. With central and gestational diabetes insipidus the treatment is with the drug desmopressin which is a synthetic replacement for vasopressin. For nephrogenic diabetes insipidus treatment is with the diuretic hydrochlorothiazide a drug that acts to inhibit the kidney’s ability to retain water. Dispogenic diabetes insipidus the drug carbamazepine is used because it is a anticonvulsant and mood stabilizing drug.
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