Diabetes Insipidus The Rare Diabetes Type
Diabetes Insipidus is a rare type of diabetes not heard of very often. It is NOT diabetes mellitus of any type, but is diabetes that comes on mostly from an endocrine problem. The classic signs are:
Intense urinary frequency
Nocturia which means awakening at night to urinate
Thirst which is often very intense like in Type 1 or 2 diabetes.
Bedwetting. Urine output is rapidly increased since it is never concentrated.
There are four types of diabetes insipidus, and each of these types has a different cause. And because each type has a different cause, it must be treated differently.
Lack of a hormone called vasopressin, which is affiliated with the kidney to reduce urine output is referred to as neurogenic DI. This is due to destruction in the pituitary gland that normally creates vasopressin. It can also be called pituitary DI. Brain injuries including tumors, infections, head injuries, infiltrations, or underlying diseases can destroy the pituitary. This in turn, can cause DI. This type of DI is usually lifelong, and no cure is possible. Treatment for the diminishment of the DI symptoms can be given using vasopressin drugs. There are cases where DI is connected with other abnormal pituitary hormones. In this case, treatments are needed for problems related there.
Sometimes a pregnancy can cause a lack of vasopressin hormone. This happens when the pituitary gland is either damaged or else the placenta has destroyed the hormone too quickly. This is referred to as gestagenic or gestational DI and treated with vasopressin drugs. This type of problem usually will go away after delivery.
Nephrogenic DI is often caused by kidneys that do not respond to vasopressin medications. The cause of this is usually an underlying kidney problem, genetic defects, and in some cases drugs that counteract with other drugs in the system. This type of DI is more serious, and not curable. There are limited treatments available to get relief from the symptoms.
Dipsogenic DI occurs in the body when vasopressin is being suppressed by a high intake of fluid. There is an abnormality in the brain that controls and regulates thirst which is labeled dipsogenic DI. The only way to tell for sure is to measure the vasopressin hormones during fluid deprivation, a type of stimulus test, or watch what happens with desmopressin treatment. Desmopressin treatment will eliminate the constant urination, but not the excessive thirst and drinking liquids all the time. Dipsogenic diabetes insipidus will result in water intoxication, which is a medical problem that brings on headache, lack of appetite, tiredness, nauseated feelings, and an abnormally large decrease in plasma sodium concentration. This disorder cannot be treated at the present time aggressively. Medications can be given to correct the nocturia, but otherwise there are not too many treatment options for doctors to consider at the present time.
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