Today I am goanna
present Diabetes Insipidus. So What is Diabetes? It literally means a large
amount of water goes through, since dia- is a prefix means through, and betes
is the suffix means to go.
Diabetes Insipidus is a disorder characterized by abnormal high amount of urine with no taste. Cause of Diabetes Insipidus. The main cause of it is that the reabsorption mechanism within the kidney is not functioning properly. The picture on the right shows that fluid is not able to reabsorb back to the blood vessels during the formation of urine. This causes the urine to be severely diluted.
Medically speaking it
is a general term for disease characterized by excessive discharge of urine. There
are no main types of diabetes: Diabetes mellitus and Diabetes Insipidus.
Diabetes Mellitus is a disorder characterized by abnormally high blood sugar
level, which causes glycosuria, which is glucose within urine. Mellitus by the
way means sweet.
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DIABETES INSIPIDUS |
Diabetes Insipidus is a disorder characterized by abnormal high amount of urine with no taste. Cause of Diabetes Insipidus. The main cause of it is that the reabsorption mechanism within the kidney is not functioning properly. The picture on the right shows that fluid is not able to reabsorb back to the blood vessels during the formation of urine. This causes the urine to be severely diluted.
There
are two main causes for the reabsorption to go wrong, which leads to two types
of DI.
The first type is a
lack or low level of Antidiuretic Hormone. And the other one is due the failure
for kidney to respond to the Antidiuretic Hormone. One type of DI is known as
central Diabetes Insipidus. It is characterized by the lack or low level of
Antidiuretic Hormone. So what is Antidiuretic Hormone. It's also called
Vasopressin. It is a hormone produced by the Hypothalamus in the brain, stored
and released by the pituitary gland. Its main function is to stimulate the
reabsorption of water by the renal tubules. And now the reabosorption is
hindered by low level or complete lack of ADH, which causes excessive loss of
water through urine. And the main cause for this is due to the damage of
Hypothalamus or pituitary gland by surguries,imflammation, tumor, etc. And the
disease may also be genetic.
The other type of DI is known as Nephrogenic
Diabetes Insipidus It is characterized by the failure of the kidney to respond
to ADH, as shown by the figure on the right. As a result, reabsorption is
hindered as well. This causes a large amount of diluted urine. Similar to
central Diabetes insipidus, it can also be genetic. But for acquired disorder,
there are factors include: blockage in the urinary tract, High calcium levels,
low potassium levels and use of certain drugs such as lithium. So what are the
symptoms of DI? Both types of DI basically have the same symptoms. The most
obvious one is polyuria, which is excessive urination. About 3 liters to 15
liters of urine per day.
That's really a lot
because normal people only urinate about 1 Liter to 1.5 liter a day. And due to
the excessive loss of water, polydipsia results (which is excessive thirst).
And most of the time it is uncontrollable and people need a large amount of
water and even craving for ice water. And if fluid intake is not enough, it
will cause dehydration. Symptoms due to dehydration include: dry skin, fatique
and lethargy, headache, lower alertness, Tachycardia (which is rapid heartbeat)
and even possible coma. What are the treatments available to diabetes
insipidus?
Since both types cannot
be cured completely, the treatment is most likely life-long. For central DI,
which is due to lack or low level of ADH, desmopressin can be given as nasal
spray, tablets or injections. Desmopressin is the synthesis form of ADH. It
serves to control urine output, fluid balance and prevent dehydration. And for
mild cases for central DI, a prescription for a certain amount of water intake
can be given to ensure proper hydration.
On the other hand, for
nephrogenic DI, which is due to the irresponsive of kidney to ADH, a large
amount of fluid intake is needed to prevent dehydration. Diet of low-sodium,
low-protein can be given to reduce urine output. And finally medications such
as nonsteroidal anti-imflammatory drugs and thiazide diuretics can be given to
relieve the symptoms.
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