Diabetes insipidus is a pathology that is accompanied by a violation of the synthesis of antidiuretic hormone or susceptibility to it. As a result, the natural course of reabsorption processes in the renal tubules changes. This disease is diagnosed in representatives of both sexes, regardless of age (children are also affected).
Of course, many people are looking for additional information. What is a pathology and what symptoms are accompanied? What is the difference between diabetes and diabetes insipidus? What are the causes of the development of the disease? Are there effective treatments? How dangerous is the pathology? The answers to these questions are important.
What is a pathology?
Diabetes insipidus is a pathology that is relatively rare. Nevertheless, it is dangerous. The disease is associated with a deficiency of antidiuretic hormone or with a decrease in the sensitivity of renal tissues.
Vasopressin (an antidiuretic hormone) is synthesized by the hypothalamus and accumulates from the back of the pituitary gland. This substance is extremely important for normal life, as it regulates the water balance and controls the osmotic composition of internal fluids (including blood).
With a deficiency of this hormone or insensitivity to it, the intensity of the processes of reabsorption of fluid in the renal tubules decreases. As a result of this, more volumes of low-density urine are excreted from the body. The body tries to compensate for the lack of fluid, creating a feeling of constant thirst.
This disease is equally affected by both men and women. By the way, in veterinary practice, cases of such a violation are also recorded (diabetes insipidus occurs in dogs and other pets).
Varieties of ailment
Depending on the reasons, in modern medicine there are two types of diabetes insipidus:
- Central - associated with impaired synthesis of vasopressin. This form of pathology can be idiopathic (the causes of the development of the disease are not completely clear to the medical community, but are usually associated with a genetic predisposition) or symptomatic (develops against the background of brain injuries, operations on the hypothalamic-pituitary system, brain infections).
- The renal form is associated with a violation of the sensitivity of kidney tissue to the effects of antidiuretic hormone.
Causes of the central form of diabetes
If we talk about the central form of pathology, which is associated with a violation of the synthesis of antidiuretic hormone in the structures of the brain, then the list of reasons can include:
- tumors in the hypothalamus and pituitary gland (both benign and malignant);
- complications after neurosurgical operations (quite often, removal of the pituitary adenoma leads to disruption of the synthesis and secretion of vasopressin);
- inflammation of the membranes of the brain;
- head injuries;
- cerebrovascular accident, for example, malnutrition of the hypothalamic-pituitary system;
- the spread of metastases in cancer in certain structures of the brain;
- syphilis (in this case, the infection often affects the central nervous system);
- there is a genetic predisposition;
- rarely, infections such as influenza, SARS lead to the development of such a disease.
Renal pathology: risk factors
If we are talking about a violation of the sensitivity of renal tissues to antidiuretic hormone, then the list of reasons looks different:
- most often the cause is a congenital disturbance of sensitivity;
- diseases that are accompanied by damage to the tubules or medulla of the kidney;
- sickle cell anemia;
- amyloidosis or polycystic kidney disease;
- chronic forms of renal failure;
- a sharp increase or decrease in the level of calcium in the blood;
- taking certain medications, including Demeclocilin, lithium preparations;
- risk factors include exhaustion and old age.
It is worth noting that in about 30% of cases, the cause of diabetes insipidus development cannot be determined.
What symptoms should I look for? Features of the clinical picture
Signs of diabetes insipidus may appear suddenly or their intensity increases gradually. The daily volume of urine increases sharply - up to 3-15 liters. The patient is tormented by constant thirst. Since a large amount of fluid constantly enters the stomach, it gradually stretches, and sometimes it drops. Water deficiency affects the synthesis of digestive enzymes, as a result of which a sick person loses his appetite, suffers from nausea and constipation. It is also possible the development of gastritis and colitis.
External signs of dehydration also appear - the skin and mucous membranes become dry. The patient loses weight and often complains of dry mouth. The intensity of perspiration decreases. Patients suffer from constant fatigue. Perhaps a violation of the heart rhythm, a decrease in blood pressure.
Abundant urination also torments a person at night. Lack of sleep affects the emotional state. Mental activity decreases, patients complain of insomnia. Symptoms include increased irritability, neurosis, psychosis. Diabetes mellitus in women is sometimes accompanied by menstrual irregularities and the further development of infertility.
Features of the disease in childhood
Diabetes mellitus in children is also recorded quite often. The clinical picture in children older than three years is accompanied by approximately the same symptoms as in adults, although it is more lubricated. The child has night urinary incontinence, poor appetite, vomiting after eating, and chronic constipation. Some guys complain of joint pain. If you do not diagnose the disease on time, then a significant delay in mental and mental development is possible.
Even more serious symptoms are accompanied by diabetes insipidus in newborns. As a rule, the baby quickly loses weight, his body temperature can either increase or suddenly decrease. The child is restless, often crying, but there are no tears (or there is not enough liquid). Urination often occurs, and a large amount of fluid is released.
The skin gradually loses elasticity, which is associated with gradual dehydration. Frequent vomiting is observed. During the examination, the doctor notes an increase in heart rate. Unfortunately, the infant cannot report its thirst. Dehydration can lead to seizures and sometimes death. That is why in no case can you ignore the symptoms.
Possible complications
Diabetes mellitus responds well to treatment. But in the absence of therapy, a violation of the water-electrolyte balance is fraught with dangerous complications. First of all, pathology affects the work of the cardiovascular system - patients develop various forms of arrhythmias, hypertension.
Perhaps a violation of the nervous system. Patients who do not receive proper treatment often suffer from sleep disturbances, depression, nervousness and other mental disorders.
Diabetes mellitus in men can lead to problems with achieving an erection, sometimes even impotence. If a person consumes less fluid than excreted by the kidneys, then dehydration occurs, which is accompanied by a sharp weakness, blood clotting, convulsions, a sharp decrease in blood pressure, which often ends in collapse.
Diabetes insipidus: diagnosis
If you have the above symptoms, you should consult a doctor. As a rule, during the collection of an anamnesis, a specialist may already suspect diabetes insipidus. Urine is excreted in large quantities (more than 3 liters per day), patients complain of intense thirst and nightly urination. Further analyzes are carried out:
- tests are performed to determine the osmolarity of blood and urine, it is also important to determine the level of nitrogen, calcium, sodium, sugar and urea;
- determine the relative density of urine;
- mandatory is echoencephalography;
- X-rays of the Turkish saddle, magnetic resonance imaging and computed tomography are performed in order to detect damage to the hypothalamic-pituitary system;
- ultrasound of the kidneys and excretory urography are also necessary.
Central diabetes insipidus: treatment
If the volume of urine excreted per day does not exceed 4 liters, then therapy may not be necessary at all - the patient is only recommended to maintain a balance of fluid intake and regularly take tests.
In other cases, doctors usually prescribe Minirin, which contains synthetic vasopressin. Dosage is selected individually. Such drugs as Miskleron and Carbamazepine stimulate the production of antidiuretic hormone. If the patient combines diabetes and diabetes insipidus, then the drug Chlorpropamide is introduced into the treatment regimen.
Treatment of renal pathology
If we are talking about the kidney form of the disease, then patients are prescribed diuretics, in particular, Triampur, Hydrochlorothiazide. These drugs interfere with the absorption of chlorine by the urinary tubules, resulting in increased reverse absorption of water.
Sometimes anti-inflammatory drugs, such as Aspirin and Ibuprofen, are also included in the treatment regimen.
Symptomatic therapy is also carried out. For example, the treatment of diabetes insipidus in women may include measures to restore the normal menstrual cycle or treat infertility.
Proper diet
Regardless of the causes of diabetes insipidus, its form and severity, therapy necessarily includes a diet. An appropriate diet helps cope with thirst and increased urine output, as well as replenish the nutrients that the body loses with fluid. Here are some rules:
- First you need to sharply limit the amount of salt consumed (no more than 4-5 g per day). In this case, it is recommended to salt the dish after its preparation, and not in the process.
- Dried fruits are necessarily included in the diet, as they are rich in potassium. This mineral enhances the synthesis of vasopressin.
- Doctors recommend giving up alcoholic drinks and sweets, as these products only increase thirst.
- The diet should include berries, vegetables, fruits (fresh), milk and dairy products. Fruit drinks, unsweetened compotes, freshly squeezed juices are suitable for drinking.
- It is important that the brain receives a sufficient amount of phosphorus, so the daily menu should contain seafood, low-fat fish. Periodically, you can take fish oil in capsules.
- Fats and carbohydrates should be present in the diet, but the amount of protein should be limited, since this increases the load on the kidneys. It is allowed to eat lean meats and eggs (but in reasonable quantities).
Traditional medicine
Some plants have healing properties that can be used to correct the body. For instance:
- An infusion of burdock roots will help cope with thirst. 60 g of raw materials (sold at the pharmacy) should be placed in a thermos and pour a liter of boiling water. Leave the mixture overnight, then filter. You need to drink three times a day for 2/3 glasses.
- For the same purpose, tea is used from young walnut leaves, which are very easy to get. Pour a teaspoon of chopped leaves with a glass of boiling water and insist. The product is ready to use.
- Cope with irritability, insomnia and neurosis can tincture of valerian and motherwort, which are sold in almost every pharmacy.
Predictions for Patients
What should a patient be diagnosed with diabetes insipidus count on? Treatment in this case gives good results. If the cause of hormonal failure is a tumor in the brain or infection, then with the right treatment regimen (for example, surgery), you can permanently get rid of the problem.
But in the vast majority of cases, diabetes insipidus is persistent. With properly organized treatment, it is possible to maintain a normal quality of life and even the patient's performance. Complications (including deadly ones) are recorded only if the person has not been provided with appropriate assistance.