Diabetes insipidus

Diabetes insipidus

Description of diabetes insipidus

Diabetes insipidus is a group of relatively rare diseases, whose essence is the disruption of the management body of water – either on the basis of endocrine and metabolic disorders, or kidney disease or psychogenic illness. Endocrine disorders mean illness or damage to endocrine glands, ie. Body forming hormones. There is such a body hypothalamus or pituitary gland. The primary symptom of this group of diseases is large thirst (polydipsia) and the production of excessive amounts of urine (polyuria), which may benefit a significant failure to achieve 20 to 30 liters per day. Diabetes insipidus is not the same as diabetes mellitus (ie diabetes). These are diseases that are very similar – in terms of symptoms (frequent urination and thirst), but with nothing to do.

Diabetes insipidus is divided into the central or neurogenic (having a cause in the hypothalamus of the brain =), as nephrogenic (renal impairment arises), less common is diabetes insipidus gestational (pregnancy) and dipsogenní (primary), whose cause is not known. Among dipsogenní (primary) diabetes insipidus belong the so-called. Psychogenic diabetes insipidus, the essence of which is probably the psychiatric illness.

There are both forms of innate and acquired. Acquired forms of diabetes insipidus are not more frequent.

The cause of central diabetes insipidus is an insufficient amount of antidiuretic hormone (ADH =, vasopressin, vasopressin), which normally controls (increases) the water reabsorption by the kidneys rather than its exclusion from the body into the final urine. Patients thus produce large amounts of dilute urine per day, which can lead to dehydration, lack of sleep, fatigue, reduced performance and subsequent mental disorders.

Special inherited variant of central diabetes insipidus is called. Wolfram syndrome (syndrome DIDMOAD) – it is the simultaneous occurrence of diabetes insipidus, diabetes (diabetes mellitus), atrophy of the optic nerve (ie. Blindness) and deafness. Like other inherited forms of diabetes insipidus occurs equally often in men and women, since it is inherited autosomal (ie not through sex chromosomes sex-linked as in nephrogenic diabetes insipidus).

The essence of nephrogenic diabetes insipidus numbness kidney (receptor in renal tubules – tubules) to antidiuretic hormone (ADH). The governor consists, however, finds application in the kidney and the result is therefore the same as in the previous case. Nephrogenic diabetes insipidus is more likely to result when, after taking certain medications such as. Lithium. The inherited form is a hereditary disease linked to the X chromosome with the prevailing handicapped men.

Gestational (pregnancy), diabetes insipidus occurs only in pregnant women and is caused by the enzyme vasopressinazou, which is produced by the placenta. This enzyme catabolizes decomposition of antidiuretic hormone, resulting in a deficiency and the same effects as the other types of diabetes insipidus. This type of diabetes insipidus usually disappear within 4-6 weeks after birth.

Risk factors for diabetes insipidus

Risk factors include any autoimmune disease (in the family), head injuries (especially car accidents), brain surgery, tumors of the hypothalamus and pituitary gland, inflammation of the brain (meningoencephalitis) and diabetes insipidus in the family (familial affection).

Prevention of diabetes insipidus

Disease is no way to specifically prevent. While it is possible to avoid injuries of the head by using protective gear such as a helmet, but it can not completely prevent injury. Likewise you can bevaccinated against encephalitis (tick-borne encephalitis), which is able to cause diabetes insipidus.

Symptoms of diabetes insipidus

Diabetes insipidus manifests thirst (polydipsia) and the formation of excessive amounts of urine (polyuria) and hence the more frequent urination. Lack of water in the body can cause dehydration, elevated body temperature and nephrogenic diabetes insipidus, which is inborn and is reflected from birth, can cause mental retardation. Diabetes insipidus is manifested at any age, usually 10 to 20 years. Patients usually have other problems than frequent urination and excessive thirst. Repeated urination at night (nocturia) leads to chronic fatigue and underperformance child at school.

More frequent than the full form (absolute deficiency of antidiuretic hormone) is called. Incomplete diabetes insipidus, the patient increasing the power just over 2.5 liters of urine per day (which is the upper limit of the normal quantity of urine per day). In nephrogenic diabetes insipidus patient urine rarely more than 4 liters of urine per day. Otherwise, the normal value for the amount of urine per day, patients are between 4-8 liters. Extreme values around 20-30 liters of urine per day are very rare.

Treatment of diabetes insipidus

Treatment depends on the cause of the disease. Missing antidiuretic hormone is replaced with a synthetic analogue – desmopressin in the form of nasal drops, tablets or injection (MINIRIN). In the case of kidney insensitivity to antidiuretic hormone administration of desmopressin should not have the effect, therefore, it served a drug stimulating reabsorption of sodium ions at each other in the kidneys, bind water (hydrochlorothiazide and indomethacin) and the body of her so forthcoming. It is important to reduce salt in the diet and to adhere to drinking regime.

How can I help myself

Disease should always be treated by a specialist. Significant is the fluid intake to prevent dehydration.

Any patient with this disease should carry a document that, if necessary, the highlights of his disease (when falling into a coma, etc.).

Complications of diabetes insipidus

Very serious complication of the disease is the formation of dehydration, especially in patients who are unconscious and unable to regulate fluid intake sensation of thirst. In the case of nephrogenic diabetes insipidus in early childhood possible development of mental retardation varying degrees – by slight memory disorder after imbecility and then growth delay.

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