Perhaps, there’s no need to talk about what diabetes is. We all know about this disease, and some, unfortunately, know about it firsthand. But what is the difference between this pathology and diabetes insipidus? Symptoms and treatment of this disease will be discussed later in the article.
What is the specificity of the disease?
In a healthy person, blood sugar is neutralized with the help of the hormone insulin, which is produced by the pancreas - these are the characteristics of physiology. However, if it is insufficient or the kidney tissue has lost sensitivity to its effects, the concentration of sugar in the blood rises, which then passes into the urine.
An interesting nuance: the word "diabetes" in Latin from diabetes mellitus means "passing by." The doctors who helped people in the Renaissance (XIX century) did not have modern clinical and laboratory tools, and therefore were forced to draw up a conclusion, tasting the patient's urine. This is probably one of the reasons explaining why an appointment with a certified doctor was always worth an impressive amount of money in those days.
Thus, one of the symptoms of diabetes insipidus in men and women can be considered the presence of glucose in the urine, and the second is polyuria. This term doctors mean an increased volume of urinary fluid produced during 24 hours. By the way, the second name of the disease is "diabetes insipidus."
Etiology of the disease
All symptoms of diabetes insipidus are based on the main clinical manifestation of the disease - the loss of the ability of the kidneys to concentrate urine. This is an endocrine disorder that occurs as a result of a deficiency of antidiuretic hormone. The main signs that make it possible to suspect diabetes insipidus include:
- excruciating thirst all day and night;
- excessive secretion of “watery” urine.
In fairness, it is worth noting that the natural rate of primary urine production in a healthy person is approximately 90-100 ml per minute. Following this logic, about 6 liters of natural biological fluid should be formed in an hour! However, almost all of this urine is susceptible to a process of reverse absorption into the renal tubules. This function is regulated by the antidiuretic hormone, which is produced by the pituitary gland. It is this substance that plays a major role in water-salt metabolism.
The frequency of diagnosis of this disease is the same for everyone. There are symptoms of diabetes insipidus in children and adults, regardless of gender. At risk are predominantly young people aged 20-35 years.
Central form of the disease
There are two types of diabetes insipidus - central and peripheral. In the first case, we are talking about malfunctions of the brain, which for some reason does not produce antidiuretic hormone. As a rule, central diabetes insipidus is a secondary disease with more serious pathologies:
- cancer and non-malignant tumors of the pituitary gland and hypothalamus;
- violation of the blood supply to the pituitary gland and hypothalamus due to an ischemic stroke;
- the formation of post-traumatic fibrocystic tissues in the pituitary gland;
- foci of metastasis in the hypothalamic-pituitary system;
- post-infection syndrome.
The latter factor can provoke the onset of symptoms of diabetes insipidus after a severe infection (flu, SARS, herpes, measles, chicken pox, scarlet fever, syphilis, etc.).
Peripheral type diabetes
This is the second form of the disease. Another name is also known - nephrogenic diabetes insipidus. This disease develops due to kidney dysfunction. With the nephrogenic form, the brain and endocrine glands produce a sufficient amount of antidiuretic substance, but the excretory system of the body does not perceive its effect. Accordingly, the initially excreted urine is not absorbed, its amount is not reduced.
In pregnant women
By the way, doctors conditionally isolated the third form of diabetes insipidus, originating from peripheral. It can occur during pregnancy, but in most cases passes without intervention after childbirth or at the end of the gestation period. Its development is associated with placental enzymes that can destroy the molecules of the antidiuretic hormone, which leads to its inefficiency.
They do not need additional explanation of the causes of diabetes insipidus in women. Symptoms of this nephrogenic form of diabetes are explained by unstable kidney function, which can cause:
- congenital malformations and infection of the brain substance of the organ;
- glomerulonephritis;
- anemia;
- renal polycystic and amyloidosis;
- chronic renal failure;
- prolonged damage to the tissues by toxins (with abuse of alcohol, drugs).
It is impossible to ignore the fact that diffuse lesions of both organs play a role in the development of peripheral diabetes insipidus. In the presence of at least one healthy kidney that has full blood supply and urination, there is no disturbance in diuresis.
Cryptogenic diabetes
In case histories of elderly patients, specialists often point to the cryptogenic form of diabetes insipidus. Symptoms of such a disease, as a rule, do not differ significantly from the central or peripheral type of the disease. The frequency of diagnosing such a diagnosis is extremely high - it reaches 30%. Multiple endocrine disorders are a favorable background for the development and course of cryptogenic diabetes insipidus.
Clinical picture
So, the symptoms of diabetes insipidus in women are no different from the manifestations of the disease in the male population. Antidiuretic hormone occurs in each of us in the same concentration, regardless of gender.
In this case, the consequences of the development of the disease in representatives of the weaker sex may differ. Lack of timely treatment of symptoms of diabetes insipidus in women can lead to infertility. As the pathology progresses, there are violations of the ovulation-menstrual cycle, amenorrhea. The severity of clinical manifestations is determined by two factors:
- the level of estrogen and antidiuretic hormone in the blood;
- susceptibility to it of receptors located in the renal parenchyma.
Against the background of the lack of normal receptor receptivity and insufficient production of hormones, the symptoms of the disease acquire maximum severity. The main symptoms of diabetes insipidus in women, however, as in men, are:
- constant exhausting thirst;
- frequent and profuse urination.
The daily volume of fluid excreted by the body in severe forms of the disease can reach 25 liters. Therefore, no excretory system can cope with such a load. It is quite natural that the compensatory capabilities of the body against the background of a progressing disease are depleted. This is what causes the secondary symptoms of diabetes insipidus. These are considered:
- dry mouth and mucous membranes;
- sore throat;
- lack of natural moisture in the epidermis;
- rapid weight loss;
- development of enuresis at night (the result of a weakening of the sphincter of the bladder due to increased load);
- weakness and decreased performance;
- prolapse and distension of the walls of the stomach (gastroptosis).
Probable complications
Due to tissue dehydration and an enormous water load in the intestinal lumen, digestive insufficiency and dysbiosis may develop, disruptions occur in the production of bile, gastric and pancreatic juice. The ingestion of a large amount of water leads to distension of the ureters and bladder. Increased sweating affects mainly men with diabetes insipidus.
Treatment of symptoms caused by exicosis (dehydration) cannot be postponed until later. Regular fluid loss leads to heart rhythm disturbances and lowering blood pressure. In patients who have long been suffering from diabetes insipidus, the blood acquires pathological density, leading to thrombosis and, as a consequence, heart attacks, strokes. Thus, the constant pumping of large volumes of water in the body greatly depletes the patient.
Disease at an early age
Symptoms of diabetes insipidus in children are difficult to recognize. Pathology is especially dangerous for infants - the organisms of babies become dehydrated very quickly. A child with diabetes insipidus refuses breast milk; instead, he drinks greedily only water. But, unfortunately, parents do not always guess what is the matter, and try to feed the crumbs, who simply can not say about their excruciating thirst. In infants suffering from this ailment, the count goes on days. Without timely initiation of therapy, the child dies.
Parents should be alert for such symptoms of diabetes insipidus in a baby up to a year:
- crying without tears;
- springing of the fontanel;
- weak, barely audible voice;
- cramps
- fainting state.
Little information is available on the causes of this disease in children. Experts believe that the pathology is transmitted hereditarily or is the result of an abnormal intrauterine formation of the central nervous system.
Diagnosis of diabetes insipidus
According to the symptoms, it is not difficult to determine the disease in the predominant number of cases. And yet, on the basis of patient complaints alone and a pronounced clinical picture, the doctor is not able to establish a diagnosis and does not have the right to prescribe treatment. To confirm the pathology, it is necessary to determine the level of antidiuretic hormone in the blood, to examine the performance of the kidneys. It is important to understand that establishing a diagnosis is only half the battle, and a much more difficult task is to find a provoking factor.
Diagnosis of symptoms of diabetes insipidus in women and men is a set of mandatory research procedures, which include:
- MRI
- angiography of cerebral vessels;
- tests that determine the level of hormones;
- urography and ultrasound of the kidneys;
- study of ions, osmolarity of electrolytes in blood plasma and urine.
Treatment
With a mild form of diabetes insipidus, eliminating the cause naturally leads to the disappearance of clinical manifestations. If the diagnosis did not allow obtaining information about the causes of the disease, while the daily volume of urine excreted does not exceed 3-4 liters, it is recommended to adjust the diet and drinking regimen.
Severe diabetes insipidus, characterized by a sharp decrease in the level of antidiuretic substances in the blood, requires replacement therapy with desmopressin, a synthetic analogue of the natural hormone. In the pharmacy sale, this drug is better known under the name "Minirin", it is available in tablet form.
Since the norm of the presence of the hormone directly depends on its deficiency, during the first week of treatment an individual selection of the dose is carried out, which is gradually increased until the patient's satisfactory health is restored. Usually, Minirin is taken three times a day.
In central forms of diabetes insipidus, therapy is carried out using drugs that stimulate the secretion of the hormone. The most famous is the Miskleron preparation. To combat convulsive attacks, "Carbamazepine" is used.
In the case of a peripheral form of pathology, complex treatment is required. Patients are prescribed drugs from the group of non-steroidal anti-inflammatory drugs and cytostatics. Of great importance is the minimization of salt and sugar intake.
Forecast and chances of recovery
Diabetes insipidus is a typical disease that requires lifelong monitoring and taking maintenance drugs. The likelihood of a complete cure increases with the identification of a factor provoking the disease and its elimination.